Abstract
The patient in our report was a 22-year-old woman who was driving a car and sustained injuries in a head-on collision with an oncoming car. The patient was in shock and urgently transported to our hospital. Pericardial effusion was observed on transthoracic echocardiography. The patient was diagnosed with cardiac tamponade and underwent pericardiocentesis and drainage. The patient recovered from shock after drainage, and a trauma pan-scan was performed after the primary survey. The cause of cardiac tamponade was determined to be intrapericardial inferior vena cava injury. Artificial ventilation was performed in the ICU using a conservative multidisciplinary treatment approach. However, the patient developed left hemiparesis on the third day of hospitalization. Head CT/MRI showed cryptogenic stroke. Transesophageal echocardiography showed that the source of paradoxical cerebral embolism was a thrombus in the inferior vena cava that reached the cerebral circulation through a patent foramen ovale (PFO). The patient was transferred to a rehabilitation hospital on the 33rd day of hospitalization and was discharged home 2 months later. She underwent PFO closure with an Amplatzer PFO Occluder approximately 13 months after the injury. It was usefull to hold a appropriate multidisciplinary conference to make a diagnosis and decide on courses of treatment.
