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KMID : 1034720110030010012
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Journal of Neurosonology and Neuroimaging
2011 Volume.3 No. 1 p.12 ~ p.15
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A Case of Stroke Patient with Concomitant Pulmonary Arteriovenous Malformation and Patent Foramen Ovale: Transcranial Doppler Findings
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Kim Jung-Bin
Seo Woo-Keun
Yu Sung-Wook
Oh Kyung-Mi
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Abstract
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Pulmonary arteriovenous malformation (AVM) and patent foramen ovale (PFO) have been considered as the potential source of embolism through the right to left shunt in stroke patients. We report a stroke patient who had concomitant pulmonary AVM and PFO. They are characterized as the findings of transcranial Doppler (TCD) sonographic examination. A 37-year-old woman was diagnosed as ischemic stroke in her right occipital lobe. TCD monitoring with agitated-saline contrast revealed curtain-type microembolic signals (MES). MES last for 6 minutes from the infusion of agitated-saline. Endovascular closure of pulmonary AVM changed the TCD findings into scanty MES, provoked only after Valsalva’s maneuver with short duration. We suggest that TCD with agitated-saline contrast is a useful diagnosis-tool for embolic stroke caused by both intracardiac and extracardiac shunt. Furthermore, TCD findings can be helpful to differentiate between pulmonary AVM and PFO.
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KEYWORD
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Pulmonary arteriovenous malformation, Transcranial Doppler, Microembolic signal, Brain infarction
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