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The multiple brain abscesses associated with congenital pulmonary arteriovenous malformations: a case report
Seok Han1, Dong-Jun Lim, Yong-Gu Chung
1Department of Neurosurgery, Medical College, Korea University, Seoul, Korea.
Abstract:
In this report, we describe a case of multiple brain abscesses associated with diffuse congenital pulmonary arteriovenous malformations (PAVM). Although the cases of brain abscesses associated with congenital PAVM are very rare, the brain abscess could be an initial clinical manifestation in asymptomatic PAVM as in the case presented in this report. PAVM may contribute to the development of a brain abscess by allowing easy bacterial access to systemic circulation through the right-to-left pulmonary vascular shunt, bypassing the filtering effect of the pulmonary capillaries. Hence, this association should be considered in cases with brain abscesses of undetermined etiologic factors.
Insights
Multiple brain abscesses can occur with congenital pulmonary arteriovenous malformations (PAVM). This rare association highlights PAVM as a potential cause of brain abscesses, even when the PAVM is initially asymptomatic.
Area of Science:
- Neurology
- Cardiology
- Radiology
Background:
- Congenital pulmonary arteriovenous malformations (PAVM) are rare vascular anomalies.
- Brain abscesses are serious infections of the brain parenchyma.
Observation:
- A case of multiple brain abscesses was identified in a patient with diffuse congenital PAVM.
- The PAVM was asymptomatic, with the brain abscesses presenting as the initial clinical manifestation.
Findings:
- PAVM can facilitate bacterial entry into systemic circulation via right-to-left shunting.
- Pulmonary capillaries normally filter pathogens, but PAVM bypasses this protective mechanism.
Implications:
- This association suggests PAVM should be considered in the etiology of unexplained brain abscesses.
- Early recognition of PAVM in patients with brain abscesses may improve patient outcomes.