Brain abscess caused by pulmonary arteriovenous fistulas without Rendu-Osler-Weber disease.
A 52-year-old man was admitted with a brain abscess in the left basal ganglia. He had a paradoxical brain embolic mechanism owing to a pulmonary arteriovenous fistula (PAVF) and was diagnosed as having a right-to-left shunt by transesophageal echocardiography (TEE) and transcranial color Doppler (TCD) with saline contrast medium. We determined that the brain abscess was caused by the PAVFs without Rendu-Osler-Weber disease. TEE and TCD with saline contrast medium were very useful for identifying the presence of the right-to-left shunt that caused the brain abscess.
Kawano
Hiroyuki
H
Department of Neurology, Arao Municipal Hospital, Arao. hkawanoo@gmail.com
Hirano
Teruyuki
T
Ikeno
Koichi
K
Fuwa
Isao
I
Uchino
Makoto
M
D000792:Angiography; D001164:Arteriovenous Fistula / Q000150:complications* / Q000175:diagnosis; D001922:Brain Abscess / Q000175:diagnosis / Q000209:etiology*; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000002:abnormalities*; D011667:Pulmonary Veins / Q000002:abnormalities*; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000175:diagnosis*; D017585:Ultrasonography, Doppler, Transcranial