Cryptogenic Stroke Caused by Pulmonary Arterial Venous Malformation with Massive Right-to-Left Shunt: A Case Report

Zhan, Jie; Dong, Cong; Li, Mei; Zhan, Ling; Chen, Hongxia; Lu, Liming; Liu, Jianhua

doi:10.1007/s40120-021-00275-y

Cited by 3 publications

(2 citation statements)

References 25 publications

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“…To the best of our knowledge, there were 15 cases (including the present study = 17 strokes) [Table 1]. [1][2][3][4][5][6]8,9,13,[15][16][17] e mean age was 48.3 (17-84) years, 13 (87%) were female, and NIHSS scores ranged from 0 to 27 (mean 11.6). Cerebral large vessel occlusion was present in 9/16 (56%).…”

Section: Discussionmentioning

confidence: 99%

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Mechanical thrombectomy for acute paradoxical cerebral embolism due to pulmonary arteriovenous malformation: A case report and review of literature

Inoue

Fujita

Kurihara

et al. 2023

Surgical Neurology International

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Background: We report a case of acute occlusion of the middle cerebral artery (MCA) due to pulmonary arteriovenous malformation (PAVM), for which mechanical thrombectomy was performed and a good outcome was achieved. Case Description: A 59-year-old woman presented with severe right hemiplegia and dysarthria, and a National Institutes of Health Stroke Scale (NIHSS) score of 10. Magnetic resonance imaging (MRI) diffusion-weighted imaging revealed high-signal areas in the left lenticular nucleus to the corona radiata, and right temporal lobe. Magnetic resonance angiography revealed the left MCA occlusion. Chest plain computed tomography (CT) revealed PAVM in the lower lobe of the left lung. Transvenous thrombolytic therapy was started 2 h after onset, and mechanical cerebral thrombectomy was performed with an aspiration catheter and stent retriever. A red thrombus was retrieved in one pass and complete recanalization was achieved. After treatment, her symptoms improved markedly, but a symptomatic intracerebral hematoma was observed in the contralateral right temporal lobe. The patient underwent embolization for PAVM on day 24 and was transferred for rehabilitation (NIHSS score = 2). Conclusion: Although rare, PAVM is a treatable cause of stroke in relatively young adults; thus, it is important to keep in mind the possibility of its presence.

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Section: Discussionmentioning

confidence: 99%

“…However, two patients had early recurrence [13] (2022) [13] 45/F Speech disturbance, Lt. [4] 58/M Dizziness, Rt. Jiang et al (2021) [5] 17 [17] 54/F Lt.-sided limb weakness (grade Hasegawa et al (2019) [3] 84 [9] [1] 67/F (1) Weakness in Rt. upper extremity…”

Section: Evidence For Recanalization Therapy For Stroke With Pavmmentioning

confidence: 99%

Mechanical thrombectomy for acute paradoxical cerebral embolism due to pulmonary arteriovenous malformation: A case report and review of literature

Inoue

Fujita

Kurihara

et al. 2023

Surgical Neurology International

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Diagnostic criteria for determining the type of the right-to-left shunt using contrast-enhanced transcranial Doppler ultrasound in young patients with ischemic stroke/transient ischemic attack

Karshieva

Чечеткин

Белопасова

et al. 2023

РНЖ

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Objective. To determine specific diagnostic criteria for detecting the type of the right-to-left shunt by contrast-enhanced transcranial Doppler ultrasound (cTCD) in young patients with paradoxical embolism and ischemic stroke/TIA.Material and methods. The study included 64 ischemic stroke or transient ischemic attack patients (age 28–44 years) with patent foramen ovale (PFO), atrial septal defect (ASD) or pulmonary arteriovenous malformation (PAVM). cTCD was used to assess the degree of shunting, its change during the Valsalva maneuver (VM), time to the fi rst microembolic signal (MES) detection, and the duration of MES registration.Results. According to cTCD data, 20% of patients with PFO had no shunt at rest, and 80% had a mild to moderate right-to-left shunt. After VM, a severe shunt was detected in 75% of patients in this group and a moderate shunt in 25%. All patients with ASD and PAVM had a marked shunt at rest. The difference in time to first MES detection from the start of contrast administration was not statistically significant for all groups. The duration of MES registration that indicated shunting was shorter in patients with PFO compared to those with ASD (p < 0.001) or with PAVM (p < 0.001) and it was significantly longer in patients with PAVM compared to those with ASD (p < 0.001).Conclusion. The key diagnostic criteria to defi ne the right-to-left shunt type are the functional shunt degree at rest and the duration of MES registration. Severe shunting at rest can suggest the presence of ASD or PAVM, while the duration of MES registration > 2 min suggests a PAVM.

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Positive Bubble Study But No Evidence of Interatrial Defect in a Patient with Recurrent Cryptogenic Stroke

Tabrizi¹,

Stout²,

Cahill³

et al. 2023

TJAR

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Cryptogenic Stroke Caused by Pulmonary Arterial Venous Malformation with Massive Right-to-Left Shunt: A Case Report

Abstract: Background: Pulmonary arterial venous malformation (PAVM) is an abnormal vascular malformation between pulmonary arteries and veins characterized by varying degrees of rightto-left shunts (RLS). Cryptogenic stroke (CS) due

Cited by 3 publications

References 25 publications

Mechanical thrombectomy for acute paradoxical cerebral embolism due to pulmonary arteriovenous malformation: A case report and review of literature

Mechanical thrombectomy for acute paradoxical cerebral embolism due to pulmonary arteriovenous malformation: A case report and review of literature

Diagnostic criteria for determining the type of the right-to-left shunt using contrast-enhanced transcranial Doppler ultrasound in young patients with ischemic stroke/transient ischemic attack

Positive Bubble Study But No Evidence of Interatrial Defect in a Patient with Recurrent Cryptogenic Stroke

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