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[Recurrent brain abscess associated with congenital pulmonary arteriovenous fistula: a case report].
No Shinkei Geka. 2004 Jan; 32(1):57-63.NS

Abstract

We report a rare case of recurrent brain abscess associated with congenital pulmonary arteriovenous fistula. A 52-year-old man was admitted to our hospital in October, 1999 because of a sudden stroke-like onset of right hemiparesis, right hemiparesthesia, dysarthria and sensory aphasia. He had a history of previous brain abscess in the right cerebellar hemisphere. It had been removed in 1991. CT scan at the time of the current admission disclosed a low-density area in the left parietal region. The mass was ring-enhanced after injection of contrast medium. On MRI the mass lesion was depicted as low-intensity on T1-weighted image and high-intensity on T2-weighted image. The mass was ring-enhanced after administration of Gd-DTPA. In spite of conservative treatment the size of the abscess increased considerably with marked surrounding edema. The brain abscess was successfully treated with aspiration and drainage, and the residual mass was resected. The patient also had a history of arteriovenous fistula in the lower lobe of his right lung. This had been excised in 1965. However, he had no signs, symptoms or family histories of hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber disease). Contrast enhanced CT scan of the chest showed nodular lesions connected to vascular shadows in the right lower lung field. Pulmonary angiograms also revealed multiple arteriovenous fistulas in the lower lobe of the right lung. He was not dyspneic or cyanotic, but his hypoxia, polycythemia, and recurrent brain abscess were thought to be caused by pulmonary arteriovenous fistula. The fistulas were embolized with coils via a percutaneous catheter. Pulmonary arteriovenous fistula should be treated aggressively either by surgery and/or by coil embolization in order to prevent the complication of brain abscess.

Authors+Show Affiliations

Department of Neurosurgery, Yuri Kumiai General Hospital, 38 Yago, Kawaguchi, Honjo-shi, 015-8511, Akita, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

jpn

PubMed ID

14978925

Citation

Shioya, Hitoshi, et al. "[Recurrent Brain Abscess Associated With Congenital Pulmonary Arteriovenous Fistula: a Case Report]." No Shinkei Geka. Neurological Surgery, vol. 32, no. 1, 2004, pp. 57-63.
Shioya H, Kikuchi K, Suda Y, et al. [Recurrent brain abscess associated with congenital pulmonary arteriovenous fistula: a case report]. No Shinkei Geka. 2004;32(1):57-63.
Shioya, H., Kikuchi, K., Suda, Y., Shindo, K., & Hashimoto, M. (2004). [Recurrent brain abscess associated with congenital pulmonary arteriovenous fistula: a case report]. No Shinkei Geka. Neurological Surgery, 32(1), 57-63.
Shioya H, et al. [Recurrent Brain Abscess Associated With Congenital Pulmonary Arteriovenous Fistula: a Case Report]. No Shinkei Geka. 2004;32(1):57-63. PubMed PMID: 14978925.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Recurrent brain abscess associated with congenital pulmonary arteriovenous fistula: a case report]. AU - Shioya,Hitoshi, AU - Kikuchi,Kenji, AU - Suda,Yoshitaka, AU - Shindo,Kenjiro, AU - Hashimoto,Manabu, PY - 2004/2/26/pubmed PY - 2004/3/31/medline PY - 2004/2/26/entrez SP - 57 EP - 63 JF - No shinkei geka. Neurological surgery JO - No Shinkei Geka VL - 32 IS - 1 N2 - We report a rare case of recurrent brain abscess associated with congenital pulmonary arteriovenous fistula. A 52-year-old man was admitted to our hospital in October, 1999 because of a sudden stroke-like onset of right hemiparesis, right hemiparesthesia, dysarthria and sensory aphasia. He had a history of previous brain abscess in the right cerebellar hemisphere. It had been removed in 1991. CT scan at the time of the current admission disclosed a low-density area in the left parietal region. The mass was ring-enhanced after injection of contrast medium. On MRI the mass lesion was depicted as low-intensity on T1-weighted image and high-intensity on T2-weighted image. The mass was ring-enhanced after administration of Gd-DTPA. In spite of conservative treatment the size of the abscess increased considerably with marked surrounding edema. The brain abscess was successfully treated with aspiration and drainage, and the residual mass was resected. The patient also had a history of arteriovenous fistula in the lower lobe of his right lung. This had been excised in 1965. However, he had no signs, symptoms or family histories of hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber disease). Contrast enhanced CT scan of the chest showed nodular lesions connected to vascular shadows in the right lower lung field. Pulmonary angiograms also revealed multiple arteriovenous fistulas in the lower lobe of the right lung. He was not dyspneic or cyanotic, but his hypoxia, polycythemia, and recurrent brain abscess were thought to be caused by pulmonary arteriovenous fistula. The fistulas were embolized with coils via a percutaneous catheter. Pulmonary arteriovenous fistula should be treated aggressively either by surgery and/or by coil embolization in order to prevent the complication of brain abscess. SN - 0301-2603 UR - https://www.unboundmedicine.com/medline/citation/14978925/[Recurrent_brain_abscess_associated_with_congenital_pulmonary_arteriovenous_fistula:_a_case_report]_ DB - PRIME DP - Unbound Medicine ER -