Paradoxical brain embolism mediated through a pulmonary arteriovenous malformation with hereditary hemorrhagic telangiectasia in a Japanese patient

DOI Web Site PubMed 16 References
  • Takeda June
    Department of Neurology, Kobe City Medical Center General Hospital
  • Todo Kenichi
    Department of Neurology, Kobe City Medical Center General Hospital
  • Yamamoto Shiro
    Department of Neurology, Kobe City Medical Center General Hospital
  • Yamagami Hiroshi
    Department of Neurology, Kobe City Medical Center General Hospital
  • Kawamoto Michi
    Department of Neurology, Kobe City Medical Center General Hospital
  • Kohara Nobuo
    Department of Neurology, Kobe City Medical Center General Hospital

Bibliographic Information

Other Title
  • 遺伝性出血性毛細血管拡張症にともなう肺動静脈瘻を介し奇異性脳塞栓症を発症した1例
  • 症例報告 遺伝性出血性毛細血管拡張症にともなう肺動静脈瘻を介し奇異性脳塞栓症を発症した1例
  • ショウレイ ホウコク イデンセイ シュッケツセイ モウサイケッカン カクチョウショウ ニ トモナウ ハイドウ ジョウミャクロウ オ カイシ キイセイ ノウ ソクセンショウ オ ハッショウ シタ 1レイ

Search this article

Abstract

We report a case of paradoxical brain embolism mediated through a pulmonary arteriovenous malformation (PAVM) with hereditary hemorrhagic telangiectasia (HHT). A 25-year-old right handed man was admitted to our hospital after sudden headache and visual field abnormality. In neurologic examinations, he had left superior-quadrantanopsia. Laboratory findings showed iron deficiency anemia. Diffusion weighted images disclosed a high-signal-intensity area in the right occipito-temporal lobe, and intraarterial digital subtraction cerebral angiography revealed occlusion of the right posterior cerebral artery. Transesophageal echocardiography revealed continuous right-to-left shunt. We confirmed his history of spontaneous recurrent epistaxis and the first-degree relatives with epistaxis or PAVM. A contrast enhanced CT scan of the chest revealed a PAVM. The diagnosis of paradoxical brain embolism mediated through the PAVM with HHT was, thus, established. The PAVM was occluded by using embolization coils successfully. In Asian countries, the prevalence of PAVM with HHT is thought to be lower than in European countries. We should carefully take medical and family histories, especially epistaxis, in a young stroke patient.<br>

Journal

  • Rinsho Shinkeigaku

    Rinsho Shinkeigaku 52 (3), 161-165, 2012

    Societas Neurologica Japonica

References(16)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top