A rare cause of embolic stroke in hereditary hemorrhagic telangiectasia

Nawaf Yassi; Bernard Yan; Richard Dowling; Peter J Mitchell

doi:10.1016/j.jstrokecerebrovasdis.2013.07.037

A rare cause of embolic stroke in hereditary hemorrhagic telangiectasia

J Stroke Cerebrovasc Dis. 2014 May-Jun;23(5):1245-6. doi: 10.1016/j.jstrokecerebrovasdis.2013.07.037. Epub 2013 Sep 14.

Authors

Nawaf Yassi¹, Bernard Yan², Richard Dowling³, Peter J Mitchell³

Affiliations

¹ Department of Medicine, Melbourne Brain Centre at Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia; Department of Neurology, Melbourne Brain Centre at Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia. Electronic address: nawaf.yassi@mh.org.au.
² Department of Medicine, Melbourne Brain Centre at Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia; Department of Neurology, Melbourne Brain Centre at Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia; Department of Radiology, The Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.
³ Department of Radiology, The Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.

PMID: 24045083
DOI: 10.1016/j.jstrokecerebrovasdis.2013.07.037

Abstract

A 57-year-old male patient with hereditary hemorrhagic telangiectasia presented with an acute right middle cerebral artery ischemic stroke. Investigations revealed a right middle cerebral artery M2 occlusion, hypoxemia, and a large pulmonary arteriovenous malformation and right lower limb deep venous thrombosis. Closure of the pulmonary arteriovenous malformation was successfully performed with an Amplatzer device. Catheter closure of pulmonary arteriovenous malformations in patients with hereditary hemorrhagic telangiectasia is a recognized treatment modality to prevent recurrent ischemic stroke and other embolic and hemorrhagic complications.

Keywords: Osler–Weber–Rendau; Stroke; hereditary hemorrhagic telangiectasia; pulmonary angiography; pulmonary arteriovenous malformation.

Publication types

Case Reports

MeSH terms

Anticoagulants / therapeutic use
Arteriovenous Fistula / complications*
Arteriovenous Fistula / diagnosis
Arteriovenous Fistula / therapy
Cerebral Angiography / methods
Diffusion Magnetic Resonance Imaging
Embolism, Paradoxical / diagnosis
Embolism, Paradoxical / etiology*
Embolism, Paradoxical / therapy
Endovascular Procedures / instrumentation
Humans
Infarction, Middle Cerebral Artery / diagnosis
Infarction, Middle Cerebral Artery / etiology*
Infarction, Middle Cerebral Artery / therapy
Intracranial Embolism / diagnosis
Intracranial Embolism / etiology*
Intracranial Embolism / therapy
Male
Middle Aged
Pulmonary Artery / abnormalities*
Pulmonary Veins / abnormalities*
Risk Factors
Telangiectasia, Hereditary Hemorrhagic / complications*
Telangiectasia, Hereditary Hemorrhagic / diagnosis
Treatment Outcome
Venous Thrombosis / complications*
Venous Thrombosis / diagnosis
Venous Thrombosis / therapy

Substances

Anticoagulants

Supplementary concepts

Pulmonary Arteriovenous Fistulas