Pulmonary arteriovenous malformation as a cause of embolic stroke: case report and review of the literature

Abstract

Background: Pulmonary arteriovenous malformation (PAVM) is an abnormal communication between pulmonary arteries and veins responsible for right-to-left shunting that could induce the development of embolic stroke.

Summary: We describe an 82-year-old woman without history of respiratory or neurological diseases, who presented at our observation unit with acute onset of cerebral ischemia. Clinical, laboratory and radiological findings diagnosed a PAVM.

Key messages: Usually, endovascular procedures based on embolization or, alternatively, surgery represent the recommended treatment. However, both hormonal therapy and thrombolytic therapy can be used. In our patient, treatment with warfarin induced a remission of symptoms. This strategy should be tested in larger studies.

Keywords: Acute cerebral ischemia; Pulmonary arteriovenous malformation; Warfarin.

Fig. 1

Three-dimensional reconstructions using a volume-rendering technique demonstrate PAVM in the lower zone of the lingula (arrows in a and b).