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Brain abscess associated with congenital pulmonary arteriovenous fistula

F Momma1, S Ohara, T Ohyama

  • 1Department of Neurosurgery, Yao Tokushukai Hospital, Osaka, Japan.

Surgical Neurology
|December 1, 1990
PubMed

Insights

Brain abscesses can signal an undiagnosed pulmonary arteriovenous fistula, even without typical symptoms. Early recognition of this link is crucial for unexplained brain abscess cases.

Area of Science:

  • Neurology
  • Pulmonology
  • Vascular Malformations

Background:

  • Pulmonary arteriovenous fistulas (PAVF) are abnormal connections between pulmonary arteries and veins.
  • Hereditary hemorrhagic telangiectasia (HHT) is a common cause of PAVF, though not always symptomatic.
  • Brain abscesses are serious infections requiring prompt diagnosis and treatment.

Observation:

  • A case of brain abscess associated with a congenital pulmonary arteriovenous fistula is presented.
  • A review of 52 reported cases highlights this association.
  • The patient's PAVF was asymptomatic, with no HHT indicators.

Findings:

  • Successful treatment involved repeated aspiration and drainage for the brain abscess.
  • Surgical resection of the PAVF in the right lower lobe was performed.
  • Brain abscesses can be the primary clinical presentation of an occult PAVF.

Implications:

  • This association underscores the importance of investigating unexplained brain abscesses for underlying PAVF.
  • Considering PAVF in the differential diagnosis of cryptogenic brain abscesses can improve patient outcomes.
  • Early detection and management of PAVF can prevent neurological complications.

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