ABSTRACT
Tetralogy of Fallot (FT) is the most common cyanotic congenital heart disease. FT is mainly composed of ventricular septal defect, right ventricular outflow tract obstruction, pulmonary stenosis and right ventricular hypertrophy, but also can include dextrapositioned aorta (overriding aorta), additional malformations such as atrial septal defect, and coronary artery anomalies. In the first week of life patients undergo palliative anastamosis between a pulmonary artery and subclavian artery and after they become eligible for major surgery total correction isperformed. With neurological involvement ischemic or venous stroke, syncope and seizures can occur. Generally, clinical presentation is cerebral venous thrombosis. Iİschemic stroke in children is associated with hyperviscosity and microstasis, and in adults with phlebotomy, microcytosis and traditional stroke risc factors such as hypertension, diabetes mellitus and cardiac rhythm disorders. Patients with uncorrected FT rarely survive adulthood. In this study, we present a case without total correction, who lived up to the age of 39 years and presented with arterial stroke instead of expected venous thrombosis, along with stroke mechanisms in the literature.