Connor Sophia G, Parizel Paul M, Wycoco Victor, Prentice David A
Department of Neurology, Royal Perth Hospital, Perth, Western Australia, Australia.
The Neurological Intervention & Imaging Service of Western Australia (NIISWA), Hospital Ave, Nedlands, Western Australia, Australia.
BJR Case Rep. 2022 Sep 12;8(5):20220081. doi: 10.1259/bjrcr.20220081.
We report a patient with decompensated alcoholic liver cirrhosis (Child-Turcotte-Pugh class C) who developed a left frontal cerebral AVM and a subcutaneous left temporal scalp spider naevus. Arteriovenous malformations (AVMs) are vascular abnormalities previously thought to be congenital in nature, although new research has revealed the potential for AVM formation through a two-hit hypothesis. We propose that the oestrogen-rich environment seen in chronic liver disease could act as the second hit to allow for an angiogenic state favouring AVM development. We also postulate that spider naevi are formed through a similar mechanism and may represent early-stage AVMs.
我们报告了一名失代偿期酒精性肝硬化（Child-Turcotte-Pugh C级）患者，该患者出现了左侧额叶脑动静脉畸形（AVM）和左侧颞部皮下蜘蛛痣。动静脉畸形（AVM）是一种血管异常，以前被认为本质上是先天性的，尽管新的研究通过双打击假说揭示了AVM形成的可能性。我们认为，慢性肝病中富含雌激素的环境可能作为第二次打击，从而形成有利于AVM发展的血管生成状态。我们还推测，蜘蛛痣是通过类似机制形成的，可能代表早期AVM。
