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BMJ Case Reports 2017; doi:10.1136/bcr-2017-221000
  • Unusual presentation of more common disease/injury
  • CASE REPORT

Stroke resulting from an isolated pulmonary arteriovenous malformation

  1. Sridhar Sampath Kumar2
  1. 1North Campus, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA
  2. 2Department of Cardiology, Regional Hospital of Scranton, Scranton, Pennsylvania, USA
  1. Correspondence to Jakob Saidman, jsaidman{at}tcmc.edu
  1. JS, HA and SSK contributed equally.

  • Accepted 2 October 2017
  • Published 10 October 2017

Summary

Isolated pulmonary arteriovenous malformations (PAVM) are rare, but can be responsible for paradoxical embolic events. It is important to recognise these situations early and intervene quickly to attain the best outcome. We describe the case of a 45-year-old woman with a long-standing history of migraines with aura who presented to the emergency department with left-sided weakness and slurred speech. Work-up was unclear and she was diagnosed with cryptogenic stroke. Follow-up transoesophageal echocardiogram was suggestive of an atrial septal defect, though no clear defect was evident. Pulmonary angiography revealed an isolated PAVM arising from the right lower lung segmental artery with a 2 mm feeding artery leading into 3–4 mm of dysplastic vessel that connects to the vein. The vessel was embolised successfully using a combination of a 4 mm Amplatzer Vascular Plug in the distal feeding artery and a 4 mm Nester coil proximally.

Footnotes

  • Contributors JS, HA and SSK all equally participated in researching, writing and editing of this case report.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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