Dear editor,Brain stroke in patients younger than 40 deprives society of its work force.Paradoxical brain embolism(PBE)is sometimes responsible.PBE should never be overlooked in emergency settings because its recurrence may be preventable.Ojaghihaghighi et al~([1])concluded that clinical manifestation is helpful in distinguishing stroke types before diagnostic imaging,also stating,“stroke causes Dear editor, Brain stroke in patients younger than 40 deprives society of its work force. Paradoxical brain embolism (PBE) is not responsible. PBE should never be overlooked in emergency settings because its recurrence may be preventable. Ojaghihaghighi et al ~ [[1] ) originally that clinical manifestation is helpful in distinguishing stroke types before diagnostic imaging, also stating, ”stroke causes