肺动静脉瘘致反常脑栓塞一例

Paradoxical cerebral embolism caused by pulmonary arteriovenous fistula: a case report

该例肺动静脉瘘致反常脑栓塞患者为青年女性,主要表现为右侧肢体无力,头颅磁共振成像示左侧多发急性脑梗死,病灶分属于左侧大脑中、大脑后动脉供血区。在排除了常见脑血管病发病危险因素后,发泡试验提示右向左分流,经食道超声检查排除卵圆孔未闭,行肺CT血管造影检查证实为肺动静脉瘘导致的颅内栓塞。行介入栓塞治疗后患者未再发生缺血性卒中事件。

A young female patient with paradoxical cerebral embolism caused by pulmonary arteriovenous fistula, mainly presented the right limbs asthenia, and brain magnetic resonance imaging examination showed multiple acute cerebral infarctions in the left hemisphere, which belongs to left middle cerebral artery and left posterior cerebral artery blood areas. After excluding the common risk factors of cerebrovascular disease, foaming test suggested the right-to-left shunt. The esophageal ultrasound examination excluded the patent foramen ovala. The lung CT angiography examination confirmed the intracranial embolism caused by pulmonary arteriovenous fistula. There was no recurrence of ischemic stroke after the patient was treated with pulmonary arteriovenous fistula embolization.