Paradoxical embolism: A report of 2 cases.

Rationale: Paradoxical embolism (PDE) refers to direct passage of venous thrombi into the arterial circulation through an arteriovenous shunt.

Patient Concerns: Case 1 presented with initial symptoms of shock and cerebral infarction. Case 2 developed middle cerebral artery occlusion during angiography.

Diagnoses: 2 cases were diagnosed as PDE.

Interventions: They received thrombolytic therapy and anticoagulant therapy.

Outcomes: The patients had recovery.

Lessons: This report highlights the myriad clinical manifestations of PDE and underlines the importance of meticulous history taking and physical examination for early diagnosis.