Seventeen years old man was diagnosed as left calf varicous vein and deep vein thrombosis on the same area. Three years later the patient visited for the exasperated swelling but had no sufficient warfarin therapy. At the age of 24, the patient had abrupt onset of left hemiplegia. Risk factor was monitored and patent foramen ovale and protein S deficiency were diagnosed. Simultaneously pulmonary embolism was detected and inferior vena cava filter was inserted. Nine months later from stroke, the patient had several times neurolysis on left lower extremity for spasticity. But after three days from last neurolysis we detected aggravation of lower extremity and left upper extremity swelling. He continued anticoagulation therapy. We reported a young patient with cerebral infarction by the mechanism of paradoxical embolism and upper extremity deep vein thrombosis in the lack of anticoagulation medication. (J Korean Acad Rehab Med 2005; 29: 527-530)
