Pulmonary AVM and Stroke: Case Report from Istishari Arab Hospital

Background: Pulmonary arteriovenous malformation (PAVM) is an abnormal communication between pulmonary artery and pulmonary vein which leads to multiple manifestations that range from hypoxia to neurological manifestation such as stroke due paradoxical emboli in young patients. Chest radiography and CT-enhanced studies help in diagnosis with pulmonary angiography which is considered the gold standard study for diagnosis. Management was done with embolization of the feeding artery or arteries. Case: A 31 year old female with no previous history of medical illness, presented with sudden onset left sided weakness and was diagnosed as a case of right sided ischemic stroke. After reviewing her case by multidisciplinary team and multiple imaging studies, pulmonary angiography showed that the patient had large right lower lung lobe PAVM in addition to another right middle lung lobe and left lower lung lobe smaller PAVM. After that, patient underwent embolization of with no complications. Conclusion: PAVM, although it is rare, should be considered in differential diagnosis as the cause of neurological manifestation as ischemic stroke in young patients by paradoxical emboli. Embolization of the feeding artery or arteries is the main treatment of PAVM.