For a time after it was first reported, in 1814,1 the development of brain abscess in patients with cardiac septum patency but without any of the commonly recognized sources of cerebral suppuration seemed so inexplicable that they came to be designated as "paradoxical." This term must now be regarded as faulty, in view of an explanation of the pathogenesis, though it is still useful for descriptive purposes, having ample historical support. Further, not only are these abscesses not paradoxical but they are not so rare as has been assumed. Though most textbooks still give them only slighting reference, they have been dealt with in a number of recent contributions.2 Sancetta and Zimmerman,2d who in 1950 found 42 cases in the literature and reported two more of their own, expressed the belief that this complication was fully one-quarter as common in congenital heart disease as bacterial endocarditis and
Ehni G, Crain EL. "PARADOXICAL" BRAIN ABSCESS: REPORT OF A UNIQUE CASE IN ASSOCIATION WITH LUTEMBACHER'S SYNDROME. JAMA. 1952;150(13):1298–1301. doi:10.1001/jama.1952.63680130004008b
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