Mobile aortic mural thrombus: A rare but important cause of embolic stroke

Aortic mural thrombus is a rare but important cause of embolic stroke. We report a case of embolic stroke by mobile aortic mural thrombus discuss the acute management and review the literature. A 50‐year‐old man presented sudden onset right hemiparesis and diffusion‐weighted imaging (DWI) of MRI revealed acute embolic stroke. He showed minimum vascular risk factors and no embolic sources. Transesophageal echocardiography (TEE) performed at 5 days after admission showed mobile floating mass lesion in the ascending aorta (19.3 mm × 8.94 mm). He received surgical thrombectomy to prevent further thromboembolic events and the pathological examination showed thrombotic tissue without malignant findings. Mobile aortic mural thrombus is rare but important cause of embolic stroke. Physicians should evaluate embolic sources using TEE as soon as possible in case of cryptogenic stroke in order to exclude critical condition.