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Endovascular management of pulmonary arteriovenous malformations presenting as multiple brain abscesses
  1. Surya Nandan Prasad1,
  2. Srishti Sharma2,
  3. Vivek Singh2 and
  4. Rajendra Vishnu Phadke3
  1. 1Radiodiagnosis, All India Institute of Medical Sciences, Patna, Bihar, India
  2. 2Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  3. 3Radiodiagnosis & Interventional Radiology, Apollomedics Super Speciality Hospitals, Lucknow, Uttar Pradesh, India
  1. Correspondence to Dr Vivek Singh; singhvivek79{at}rediffmail.com

Abstract

Pulmonary arteriovenous malformations (PAVMs) are rare vascular lesions characterised by abnormal connections between the pulmonary artery and vein bypassing the pulmonary capillary bed and causing right-to-left shunt. Paradoxical embolism is known to occur in these cases, leading to inoculation of septic focus in the systemic circulation. We report a case of multiple PAVMs who presented clinically with seizures and altered sensorium. On radiological work-up, multiple brain abscesses and large PAVMs were evident. The patient was successfully treated by endovascular embolisation of the PAVMs using a vascular plug and multiple coils. The patient showed complete clinical recovery and resolution of brain abscesses on follow-up.

  • Infection (neurology)
  • Neuroimaging
  • Interventional radiology
  • Interventional cardiology
  • Radiology (diagnostics)

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Footnotes

  • Contributors RVP and SNP conceived the manuscript. SS prepared the manuscript. SNP collected the images and also helped in manuscript preparation. SNP and VS edited the manuscript. The final manuscript was read and approved by all the authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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