Ischemic Stroke Secondary to Paradoxical Embolism Through a Pulmonary Arteriovenous Malformation: Case Report and Review of the Literature.
Ischemic Stroke Secondary to Paradoxical Embolism Through a Pulmonary Arteriovenous Malformation: Case Report and Review of the Literature.
复制标题
肺动静脉畸形继发于反常栓塞的缺血性中风：病例报告和文献综述。
DOI：
10.1016/j.jstrokecerebrovasdis.2018.02.015
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
A. Southerland
中科院分区：
文献类型：
--
作者：
Ryan N. Cappa;Jeanette Du;Joseph F. Carrera;Jimmy V Berthaud;A. Southerland
孤立性肺动静脉畸形(AVM)引起的矛盾栓塞症是一种罕见的缺血性卒中原因，大多数发生在尚未被诊断为其畸形的患者。我们报告一位32岁男性患者，他突然出现右侧面部无力和表情失语症。脑磁共振成像显示左侧大脑中动脉区域有急性脑梗塞，双侧小脑半球有慢性脑梗塞。心脏栓塞机制最初被认为是在几个月前诊断为心肌炎的情况下。经胸和经食道超声心动图显示高容量右向左分流，但没有间隔缺陷。经CT血管成像证实为肺AVM，栓塞术成功治疗。本报告着重介绍一例未确诊的肺AVM导致脑部反复出现矛盾栓子的病例。我们回顾了与卒中风险相关的肺动静脉畸形的流行病学、病理生理学和治疗。
Paradoxical embolism due to isolated pulmonary arteriovenous malformation (AVM) is an uncommon cause of ischemic stroke, with the majority occurring in patients who have not yet been diagnosed with their malformation. We report a 32-year-old man who presented with an abrupt onset of right facial weakness and expressive aphasia. Brain magnetic resonance imaging revealed an acute infarct in the left middle cerebral artery territory and chronic infarcts in the bilateral cerebellar hemispheres. A cardioembolic mechanism was initially considered in the setting of perimyocarditis diagnosed a few months earlier. Transthoracic and transesophageal echocardiograms revealed high volume right to left shunting, but no septal defects. A pulmonary AVM was confirmed with computed tomography angiography and fistualization was successfully treated with embolization. This report highlights a case of undiagnosed pulmonary AVM leading to recurrent paradoxical emboli to the brain. We review the epidemiology, pathophysiology, and management of pulmonary AVMs in relation to stroke risk.
影响因子：
4
作者：
Faughnan, M. E.;Palda, V. A.;Zarrabeitia, R.
通讯作者：
Zarrabeitia, R.