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Paradoxical Embolism in a Case of Hereditary Hemorrhagic Telangiectasia: Case Report with Literature Review.
Neurol India. 2020 May-Jun; 68(3):665-668.NI

Abstract

Ischemic stroke involving multiple artery territory with normal vessels gives a clue for an embolic stroke. Paradoxical embolization is a recognized cause of ischemic stroke. We describe a 48-year-old male who presented with acute onset giddiness, mild dysarthria, right hemiparesis, and ataxia. Clinical examinations indicated left cerebellar signs with right hemiparesis. Additionally, the patient had significant clubbing and mild cyanosis. A strong family history of epistaxis and hemoptysis was noted. His Magnetic resonance imaging of the brain showed acute left cerebellar and left frontal cortical infarct with normal vessels. The routine stroke and cardiac workup were normal. Chest X-ray showed bilateral lower zone opacities. Contrast-enhanced computerized tomogram (CT) of the chest showed bilateral pulmonary arteriovenous malformation. Paradoxical embolism due to pulmonary arteriovenous malformation resulted in ischemic stroke in our patient. He fulfilled all of the four criteria for diagnosing definite hereditary hemorrhagic telangiectasia. Our case highlights the importance of a systematic search for paradoxical embolism in a cryptogenic stroke.

Authors+Show Affiliations

Department of Neurology, Jubilee Mission Medical College Hospital and Research Institute, Thrissur, Kerala, India.Department of Neurology, Jubilee Mission Medical College Hospital and Research Institute, Thrissur, Kerala, India.Department of Neurology, Jubilee Mission Medical College Hospital and Research Institute, Thrissur, Kerala, India.Department of Radiology, Jubilee Mission Medical College Hospital and Research Institute, Thrissur, Kerala, India.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32643684

Citation

Baby, Neena, et al. "Paradoxical Embolism in a Case of Hereditary Hemorrhagic Telangiectasia: Case Report With Literature Review." Neurology India, vol. 68, no. 3, 2020, pp. 665-668.
Baby N, Kunnathuparambil SG, Varghese P, et al. Paradoxical Embolism in a Case of Hereditary Hemorrhagic Telangiectasia: Case Report with Literature Review. Neurol India. 2020;68(3):665-668.
Baby, N., Kunnathuparambil, S. G., Varghese, P., & Kuriakose, A. M. (2020). Paradoxical Embolism in a Case of Hereditary Hemorrhagic Telangiectasia: Case Report with Literature Review. Neurology India, 68(3), 665-668. https://doi.org/10.4103/0028-3886.288990
Baby N, et al. Paradoxical Embolism in a Case of Hereditary Hemorrhagic Telangiectasia: Case Report With Literature Review. Neurol India. 2020 May-Jun;68(3):665-668. PubMed PMID: 32643684.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Paradoxical Embolism in a Case of Hereditary Hemorrhagic Telangiectasia: Case Report with Literature Review. AU - Baby,Neena, AU - Kunnathuparambil,Sabu George, AU - Varghese,Prasanth, AU - Kuriakose,Aneesh Mangalasseril, PY - 2020/7/10/entrez KW - Embolic stroke KW - hereditary hemorrhagic telangiectasia KW - paradoxical embolism KW - pulmonary arteriovenous malformation SP - 665 EP - 668 JF - Neurology India JO - Neurol India VL - 68 IS - 3 N2 - Ischemic stroke involving multiple artery territory with normal vessels gives a clue for an embolic stroke. Paradoxical embolization is a recognized cause of ischemic stroke. We describe a 48-year-old male who presented with acute onset giddiness, mild dysarthria, right hemiparesis, and ataxia. Clinical examinations indicated left cerebellar signs with right hemiparesis. Additionally, the patient had significant clubbing and mild cyanosis. A strong family history of epistaxis and hemoptysis was noted. His Magnetic resonance imaging of the brain showed acute left cerebellar and left frontal cortical infarct with normal vessels. The routine stroke and cardiac workup were normal. Chest X-ray showed bilateral lower zone opacities. Contrast-enhanced computerized tomogram (CT) of the chest showed bilateral pulmonary arteriovenous malformation. Paradoxical embolism due to pulmonary arteriovenous malformation resulted in ischemic stroke in our patient. He fulfilled all of the four criteria for diagnosing definite hereditary hemorrhagic telangiectasia. Our case highlights the importance of a systematic search for paradoxical embolism in a cryptogenic stroke. SN - 1998-4022 UR - https://www.unboundmedicine.com/medline/citation/32643684/Paradoxical_Embolism_in_a_Case_of_Hereditary_Hemorrhagic_Telangiectasia:_Case_Report_with_Literature_Review L2 - http://www.neurologyindia.com/article.asp?issn=0028-3886;year=2020;volume=68;issue=3;spage=665;epage=668;aulast=Baby DB - PRIME DP - Unbound Medicine ER -
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