title: Stroke in hereditary hemorrhagic telangiectasia patients. New evidence for repeated screening and early treatment of pulmonary vascular malformations: two case reports.
abstract: BACKGROUND
  Paradoxical embolism due to pulmonary arteriovenous malformations is the main mechanism of brain infarction in patients with hereditary hemorrhagic telangiectasia. International Guidelines have recently been published to clarify the performance of screening tests and the effectiveness of treatment for pulmonary arteriovenous malformations.
  
  
  METHODS
  We present two cases of hereditary hemorrhagic telangiectasia patients of our hospital who experienced an acute stroke secondary to paradoxical embolism.
  
  
  CONCLUSIONS
  These two cases show that the guidelines must be followed to prevent the occurrence of ischemic stroke in patients with hereditary hemorrhagic telangiectasia, and that although they may be adequate in most cases, there are some patients who need a more personalized approach.
authors: Service de Neurologie, Centre Hospitalier Universitaire Côte de Nacre, 14033 cedex 9, Caen, France. espartacoribeiro@yahoo.com.br
authors: Espartaco
authors: E
authors: Ribeiro
authors: Julien
authors: J
authors: Cogez
authors: Emmanuel
authors: E
authors: Babin
authors: Fausto
authors: F
authors: Viader
authors: Gilles
authors: G
authors: Defer
mesh_terms: D000328:Adult; D015703:Antigens, CD / Q000235:genetics; D001165:Arteriovenous Malformations / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D004621:Embolization, Therapeutic; D000071063:Endoglin; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D009154:Mutation; D017410:Practice Guidelines as Topic; D011651:Pulmonary Artery / Q000002:abnormalities; D011667:Pulmonary Veins / Q000002:abnormalities; D011956:Receptors, Cell Surface / Q000235:genetics; D051901:Smad4 Protein / Q000235:genetics; D020521:Stroke / Q000175:diagnosis* / Q000209:etiology; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000150:complications* / Q000235:genetics; D014057:Tomography, X-Ray Computed
chemical_list: D015703:Antigens, CD; C064206:ENG protein, human; D000071063:Endoglin; D011956:Receptors, Cell Surface; C497796:SMAD4 protein, human; D051901:Smad4 Protein