title: Central nervous system lesions associated with hereditary hemorrhagic telangiectasia--three case reports.
abstract: Hereditary hemorrhagic telangiectasia (HHT) is easily overlooked in patients with central nervous system (CNS) lesions. Our clinical experience of three patients with CNS lesions associated with HHT stresses the importance of considering HHT. A 23-year-old male presented with consciousness disturbance and right hemiparesis. Emergency cerebral digital subtraction angiography revealed occlusion of the left middle cerebral artery and the left anterior cerebral artery. Pulmonary arteriography showed three pulmonary arteriovenous malformations (AVMs). A 62-year-old male presented with consciousness disturbance and sensory aphasia. Magnetic resonance imaging revealed a ring-enhanced lesion in the left temporal lobe which was removed by left frontotemporal craniotomy. The diagnosis was brain abscess. Chest computed tomography (CT) revealed two pulmonary AVMs. A 32-year-old female presented with progressive mild weakness in her left hand. Initial CT showed subcortical hemorrhage in the right frontal lobe. Cerebral angiography revealed no vascular malformations, but chest CT disclosed five pulmonary AVMs. All three patients had a family history of HHT. The possibility of HHT is important to consider in patients with cerebrovascular disease (CVD) or brain abscess to prevent complications, not only in the patients but also their blood relatives. Therefore, the medical and family history of patients with CVD or brain abscess should be investigated and HHT should be considered during the physical examination.
authors.affiliation: Department of Neurosurgery, Tokushima Prefecturol Central Hospital, Tokushima. kny1717@yahoo.co.jp
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Kuwayama
authors.forename: Kensaku
authors.initials: K
authors.lastname: Takase
authors.forename: Michiharu
authors.initials: M
authors.lastname: Kashihara
authors.forename: Hideki
authors.initials: H
authors.lastname: Hondo
authors.forename: Toshio
authors.initials: T
authors.lastname: Shigekiyo
authors.forename: Osamu
authors.initials: O
authors.lastname: Takimoto
authors.forename: Shunji
authors.initials: S
authors.lastname: Matsubara
mesh_terms: D000328:Adult; D001922:Brain Abscess / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D020766:Intracranial Embolism / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000150:complications* / Q000175:diagnosis / Q000628:therapy