Abstract
We report a case of a 67-year-old woman who demonstrated paradoxical embolic stroke with hereditary angioneurotic edema. She had been suffering from recurrent transient skin edema induced by bruising or sprain and transient whole face swelling after dental anesthesia since the age of 30. At the age of 47, this patient, her father, and her brother were diagnosed as hereditary angioneurotic edema due to familial deficiency of C1-inhibitor. At the age of 62, she was hospitalized with motor aphasia and weakness of the right upper extremity in June 2002. Brain magnetic resonance images revealed multiple infarctions in the left corona radiata and the subcortex of the parietal lobe, and transesophageal echocardiography showed patent foramen ovale. Further investigations demonstrated pulmonary embolism and deep venous thrombosis. She was finally diagnosed as paradoxical embolic stroke. In the case of C1-inhibitor deficiency, such as hereditary angioneurotic edema, a higher risk of embolism should be considered due to inhibition of fibrinogenolysis.
