脑栓塞罕见原因——肺动静脉瘘1例报告

Pulmonary arteriovenous fistula as a rare cause of cerebral embolism.A case report

肺动静脉瘘是一种绕过肺毛细血管直接将肺循环与体循环连接起来的罕见血管畸形。我们报道这例肺动静脉瘘致反常脑栓塞患者为青年女性,主要表现为突然左手活动不灵。头部MRI示脑梗死,无常见脑血管病危险因素,为探查栓子来源,完善发泡试验及胸部增强CT等检查,最终诊断为肺动静脉瘘。患者在接受抗血小板聚集药物治疗后病情明显好转。本文通过肺动静脉瘘致脑栓塞这一罕见病因报道及文献总结,提醒临床医生注意隐源性卒中病因的深入筛查。

Pulmonary arteriovenous fistula(PAVF)is a rare vessel malformation directly connecting pulmonary circulation to systemic circulation while bypassing pulmonary capillaries.This article reports a young female patient with paradoxical cerebral embolism caused by PAVF,who presented with abrupt-onset left hand weakness.Brain magnetic resonance imaging showed cerebral infarction without common risk factors for cerebrovascular diseases,and transcranial Doppler foaming test and contrast-enhanced CT examination of the chest were performed to confirm the source of embolism.Finally,the patient was diagnosed with PAVF.The patient was improved significantly after receiving anti-platelet aggregation drugs.By reporting this rare etiology of cerebral embolism caused by PAVF and summarizing related articles,this article reminds physicians of screening for the cause of cryptogenic stroke.