We report the case of a 45 year old patient who presented ischemic stroke due to the migration of a sural thrombus through a patient foramen ovale (PFO) during a Valsalva manoeuvre. The presence of PFO should be systematically evoked in case of ischemic events, especially stroke in younger adults. The diagnosis is facilitated by two-dimensional contrast echography with intravenous administration of an echo-detectable contrast agent. The clinical context and the origin of the venous thrombus in a superficial vein which remained during a stripping procedure with migration through the communicating veins of the leg were exceptional.
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