Paradoxical brain embolism caused by an arterial-venous fistula: a diagnostic pitfall

Neurol Sci. 2010 Jun;31(3):341-3. doi: 10.1007/s10072-009-0185-9. Epub 2009 Nov 21.

Abstract

The transesophageal echocardiography (TEE) and contrast-enhanced transcranial Doppler/Duplex ultrasonography (ceTCD) are complementary methods for diagnosing a right to left shunt across a patent foramen ovale. We report on a case of paradoxical embolism across a subclavian arterial-venous fistula. This case underlines the necessity of performing the ceTCD, as in this condition the right to left shunt could be detected by means of ceTCD, whereas the TEE reveals regular findings.

Publication types

  • Case Reports

MeSH terms

  • Arteriovenous Fistula / complications*
  • Arteriovenous Fistula / diagnosis*
  • Arteriovenous Fistula / diagnostic imaging
  • Cerebral Angiography
  • Diagnosis, Differential
  • Echocardiography, Transesophageal
  • Embolism, Paradoxical / diagnosis*
  • Embolism, Paradoxical / diagnostic imaging
  • Embolism, Paradoxical / etiology*
  • Female
  • Humans
  • Intracranial Embolism / diagnosis*
  • Intracranial Embolism / diagnostic imaging
  • Intracranial Embolism / etiology*
  • Ischemic Attack, Transient / diagnosis
  • Ischemic Attack, Transient / diagnostic imaging
  • Ischemic Attack, Transient / etiology
  • Subclavian Artery / diagnostic imaging
  • Subclavian Vein / diagnostic imaging
  • Ultrasonography, Doppler, Transcranial / methods
  • Young Adult