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A large pulmonary arteriovenous malformation causing cerebrovascular accidents #MMPMID25883250
Sladden D; Casha A; Azzopardi C; Manche? A
BMJ Case Rep 2015[]; 2015 (ä): ä PMID25883250show ga
The incidence of pulmonary arteriovenous malformations (PAVMs) is 2.5 in 100?000. 80% are associated with Osler-Weber-Rendu syndrome or hereditary haemorrhagic telangiectasia. We report the case of a 70-year-old man with a 6?cm spherical mass incidentally found on chest X-ray. There was a localised systolic bruit over the right lower zone posteriorly; however, he was asymptomatic. He had suffered a stroke, affecting his right hand and his speech, from which he recovered. He experienced regular transient ischaemic attacks, on an average of every 2?months. He underwent a right lower lobectomy and on ligating the right lower lobe pulmonary artery the saturations of oxygen rose from 92% to 97%, demonstrating a significant right to left extracardiac shunt. Postoperative recovery was excellent and 1?year later the patient reports no further neurological symptoms. 40% of such lesions exhibit symptoms, however, only one-third are neurological. Treatment should be by percutaneous embolisation.