Tsujimoto Kohei, Moriya Masayuki, Yaka Keiko, Kawasaki Yuko, Nakatani Rie, Naba Ichiro, Nakano Misa, Tatsumi Chikao, Yasumoto Taku, Kawahara Ryuji
Department of Neurology, Toyonaka Municipal Hospital.
Rinsho Shinkeigaku. 2014;54(4):330-3. doi: 10.5692/clinicalneurol.54.330.
The patient is a 66-year-old man with hereditary telangiectasia. He was diagnosed with pulmonary arteriovenous malformation (PAVM), which was revealed by contrast-enhanced chest computed tomography at the age of 65. He developed headache, right homonymous hemianopsia, and right hemiparesis and was admitted to our hospital. Contrast-enhanced magnetic resonance imaging revealed multiple lesions in the left hemisphere, which indicates brain abscesses. Thus, the diagnosis of brain abscess mediated through PAVM was established. Following management with drainage and coil embolization, all neurological symptoms resolved. Therefore, coil embolization should be considered for PAVM at an early stage to prevent brain abscess, even if it is asymptomatic.
该患者为一名66岁患有遗传性毛细血管扩张症的男性。他在65岁时经胸部增强计算机断层扫描被诊断出患有肺动静脉畸形(PAVM)。他出现头痛、右侧同向性偏盲和右侧偏瘫,随后入住我院。增强磁共振成像显示左半球有多个病灶,提示脑脓肿。因此,确诊为由PAVM介导的脑脓肿。经过引流和弹簧圈栓塞治疗后,所有神经症状均消失。所以,即使PAVM无症状,也应尽早考虑对其进行弹簧圈栓塞以预防脑脓肿。