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We evaluated 183 patients with brain stem ischemia for an embolic source, using transeophageal echocardiography with extensive imaging of the thoracic aorta.There were mobile,frond-like projections of aortic plaque in 7(4%)patients.The plaque originated on a wide base on the posterior aspect of the ascending aorta at its junction with the transverse arch in six patients,and on the aortic root in one.The acute event was a cerebral infarction in five patients,and a transient ischemic attack in two.This type of aortic plaque could be a previously underdiagnosed source of cerebral embolism that is now easily visualized by transeophageal echocardiography. |
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