Introduction:
An atrial septal aneurysm (ASA) is an uncommon but well-known structural saccular malformation of the atrial septum that bulges into the right or left atrium without clinical significance [1]. This lesion is commonly associated with congenital heart diseases such as patent foramen ovale, atrial septal defect, mitral valve prolapse, tricuspid valve prolapse, Marfan syndrome, sinus of Valsalva aneurysm, and aortic dissection. However, it may be caused by acquired heart disease [2,3]. It is usually asymptomatic with clinical, cardiologic, and electrocardiographic examinations failing to reveal its presence [3]. Only a few examples of atrial septal aneurysms have been described in connection with cerebral embolism; either from a paradoxical embolism of venous thrombi through a right to left shunt or passage of a thrombus formed on the left atrial side of the aneurysm with atrial fibrillation [1,2]. The following report summarizes cryptogenic stroke in an adult Sudanese female with an interatrial septal aneurysm.