Surgical Treatment of Idiopathic Multiple Pulmonary Arteriovenous Malformation Identified at the Onset of Cerebral Infarction: A Case Report

Download Download as PDF (Size:444KB)  HTML   XML  PP. 62-67  
DOI: 10.4236/ojrd.2017.72007    121 Downloads   155 Views  

ABSTRACT

Pulmonary arteriovenous malformation (PAVM), which is asymptomatic in most cases, is often identified in patients with central nervous system disorders such as brain abscesses and/or cerebral infarctions. We have reported a patient with idiopathic multiple PAVM identified at the onset of cerebral infarction. A 69-year-old woman visited the Department of Neuropathic Internal Medicine at our hospital with chief complaints of numbness in her left hand and a feeling of weakness. The patient was given a diagnosis of subacute cerebral infarction. Multiple old lacunar infarctions were also observed in the deep white matter of the left frontal lobe. Chest computed tomography showed multiple nodular structures, mainly in the right lower lung field (S8), as well as continuous arteries and veins at the site; thus, the patient was finally diagnosed with multiple PAVM. Right lower thoracoscopic lobectomy was performed, as is typical surgical practice in such cases. The patient had a favorable postoperative course, and had no recurrence of cerebral infarction. Although the patient’s lesions were mainly restricted to S8, the fact that there were multiple lesions deemed a lobectomy as the appropriate course of treatment. This case emphasizes that attention should be paid to cases of multiple PAVM since cerebral infarction may arise from the disease.

Cite this paper

Kitada, M. , Yasuda, S. , Takahashi, N. , Okazaki, S. , Ishibashi, K. , Hayashi, S. and Ohsaki, Y. (2017) Surgical Treatment of Idiopathic Multiple Pulmonary Arteriovenous Malformation Identified at the Onset of Cerebral Infarction: A Case Report. Open Journal of Respiratory Diseases, 7, 62-67. doi: 10.4236/ojrd.2017.72007.

References

[1] Faughnan, M.E., Granton, J.T. and Young, L.H. (2009) The Pulmonary Vascular Complications of Hereditary Haemorrhagic Telangiectasia. European Respiratory Journal, 33, 1186-1194.
https://doi.org/10.1183/09031936.00061308
[2] Moussoutas, M., Fayad, P., Rosenblatt, M., Hashimoto, M., Pollak, J., Henderson, K., et al. (2000) Pulmonary Arteriovenous Malformations. Cerebral Ischemia and Neurologic Manifestations. Neurology, 55, 959-964. https://doi.org/10.1212/WNL.55.7.959
[3] Lacombe, P., Lacout, A., Marcy, P.Y., Binsse, S., Sellier, J., Bensalah, M., et al. (2013) Diagnosis and Treatment of Pulmonary Arteriovenous Malformations in Hereditary Hemorrhagic Telangiectasia: An Overview. Diagnostic and Interventional Imaging, 94, 835-848. https://doi.org/10.1016/j.diii.2013.03.014
[4] Gossage, J.R. and Kanj, G. (1998) Pulmonary Arteriovenous Malformations. American Journal of Respiratory and Critical Care Medicine, 158, 643-661.
https://doi.org/10.1164/ajrccm.158.2.9711041
[5] Wong, H.H., Chan, R.P., Klatt, R. and Faughnan, M.E. (2011) Idiopathic Pulmonary Arteriovenous Malformations: Clinical and Imaging Characteristics. European Respiratory Journal, 38, 368-375. https://doi.org/10.1183/09031936.00075110
[6] Meacham, W.F. and Scott, H.W.Jr. (1958) Congenital Pulmonary Arteriovenous Aneurysm Complicated by Bacteroides Abscess of Brain: Successful Surgical Management. Annals of Surgery, 147, 404-408. https://doi.org/10.1097/00000658-195803000-00017
[7] Moussouttas, M., Fayad, P., Rosenblatt, M., Hashimoto, M., Pollak, J., Henderson, K., Ma, T.Y. and White, R.I. (2000) Pulmonary Arteriovenous Malformations: Cerebral Ischemia and Neurologic Manifestations. Neurology, 55, 959-964. https://doi.org/10.1212/WNL.55.7.959
[8] Kimura, K., Minematsu, K. and Nakajima, M. (2004) Isolated Pulmonary Arteriovenous Fistula without Rendu-Osler-Weber Disease as a Cause of Cryptogenic Stroke. Journal of Neurology Neurosurgery and Psychiatry, 75, 311-313.
[9] Cottin, V., Chinet, T., Lavolé, A., Corre, R., Marchand, E., Reynaud-Gaubert, M., Plauchu, H. and Cordier, J.F. (2007) Groupe d'Etudes et de Recherche sur les Maladies "Orphelines" Pulmonaires (GERM"O"P). Pulmonary Arteriovenous Malformations in Hereditary Hemorrhagic Telangiectasia: A Series of 126 Patients. Medicine (Baltimore), 86, 1-17.
https://doi.org/10.1097/MD.0b013e31802f8da1
[10] Lee, D.W., White, R.I.Jr, Egglin, T.K., Pollak, J.S., Fayad, P.B., Wirth, J.A., Rosenblatt, M.M. and Dickey, K.W. (1997) Embolotherapy of Large Pulmonary Arteriovenous Malformations: Long-Term Results. Annals of Thoracic Surgery, 64, 930-940.
https://doi.org/10.1016/S0003-4975(97)00815-1
[11] Minami, M., Fujii, Y., Mizuta, T., Kishima, H. and Matsuda, H. (1996) Video-Assisted Thoracoscopic Local Excision of Pulmonary Arteriovenous Fistula. The Journal of Thoracic and Cardiovascular Surgery, 112, 1395-1397.
https://doi.org/10.1016/S0022-5223(96)70161-7

  
comments powered by Disqus

Copyright © 2017 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.