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Brain Abscesses Associated with Asymptomatic Pulmonary Arteriovenous Fistulas
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논문 기본 정보

Type
Academic journal
Author
Nam, Taek-Kyun (Department of Neurosurgery, Chung-Ang University College of Medicine) Park, Yong-sook (Department of Neurosurgery, Chung-Ang University College of Medicine) Kwon, Jeong-taik (Department of Neurosurgery, Chung-Ang University College of Medicine)
Journal
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제60권 제1호 SCOPUS
Published
2017.1
Pages
118 - 124 (7page)

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Brain Abscesses Associated with Asymptomatic Pulmonary Arteriovenous Fistulas
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Brain abscess commonly occurs secondary to an adjacent infection (mostly in the middle ear or paranasal sinuses) or due to hematogenous spread from a distant infection or trauma. Pulmonary arteriovenous fistulas (AVFs) are abnormal direct communications between the pulmonary artery and vein. We present two cases of brain abscess associated with asymptomatic pulmonary AVF. A 65-year-old woman was admitted with a headache and cognitive impairment that aggravated 10 days prior. An magnetic resonance (MR) imaging revealed a brain abscess with severe edema in the right frontal lobe. We performed a craniotomy and abscess removal. Bacteriological culture proved negative. Her chest computed tomography (CT) showed multiple AVFs. Therapeutic embolization of multiple pulmonary AVFs was performed and antibiotics were administered for 8 weeks. A 45-year-old woman presented with a 7-day history of progressive left hemiparesis. She had no remarkable past medical history or family history. On admission, blood examination showed a white blood cell count of 6290 cells/uL and a high sensitive C-reactive protein of 2.62 mg/L. CT and MR imaging with MR spectroscopy revealed an enhancing lesion involving the right motor and sensory cortex with marked perilesional edema that suggested a brain abscess. A chest CT revealed a pulmonary AVF in the right upper lung. The pulmonary AVF was obliterated with embolization. There needs to consider pulmonary AVF as an etiology of cerebral abscess when routine investigations fail to detect a source.
#Arteriovenous fistula #Arteriovenous malformations #Brain abscess #Pulmonary

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Ahn KT / 2011 / Pulmonary arteriovenous fistula in a patient with cryptogenic stroke / Heart 97:2093 google schola Arivazhagan A / 2009 / An unusual etiology of recurrent cerebral abscesses-a report of 3cases / Surg Neurol 71:241~244 google schola Berthrong M / 1951 / Cerebral lesions in congenital heart disease, a review of autopsies on 162 cases / Bull Johns Hopkins Hosp 89:384~406 google schola Caroli M / 1992 / Recurrence of brain abscess associated with asymptomatic arteriovenous malformation of the lung / Neurochirurgia 35:167~170 google schola Cartin-Ceba R / 2013 / Pulmonary arteriovenous malformations / Chest 144:1033~1044 google schola

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