Isolated asymptomatic pulmonary arteriovenous malformation presenting with ischaemic stroke. (July 2016)

• Record Type: Journal Article
• Authors: Bertram, Kelly L.; Madan, Anoop; Frayne, Judith
• Is Part Of: Journal of clinical neuroscience. Volume 29(2016:Jul.)
• Page Start: 189
• Page End: 191
• Publication Date: 2016-07
• Subjects: Pulmonary arteriovenous malformation -- Stroke -- Young onset stroke; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2016.01.006
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Young onset stroke is uncommon and may not be due to traditional vascular risk factors. Isolated pulmonary arteriovenous malformation (AVM) is rare and may cause ischaemic stroke. Pulmonary AVM may be asymptomatic but can be diagnosed on simple investigations. Pulmonary AVM can produce transthoracic echocardiogram findings similar to PFO. Abstract: Young onset stroke is uncommon, and may be due to conditions other than traditional vascular risk factors. A 42-year-old woman with an ischaemic stroke was found to have left atrial bubble study positivity on transthoracic echocardiogram (TTE) suggestive of patent foramen ovale, however she also had low peripheral oxygen saturation. Investigation revealed an isolated pulmonary arteriovenous malformation (PAVM), visible on admission chest radiograph. This can cause embolic stroke and is an alternate cause of the TTE findings. The PAVM was able to be closed via endovascular intervention, removing the shunt and therefore removing her risk of recurrent stroke events. This is a rare cause of embolic stroke in young people which can be easily missed on investigation yet is amenable to treatment.