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[An Unusual Hemisphere Syndrome].

Silvio Barandun1, André Wyss1, Armin Stucki1

  • 11 Spital Simmental-Thun-Saanenland AG, Thun.

Praxis
|January 10, 2019
PubMed
Summary
This summary is machine-generated.

Hereditary hemorrhagic telangiectasia can lead to unusual neurological complications like brain abscesses. Prompt diagnosis and treatment of pulmonary arteriovenous malformations are crucial for managing these rare events.

Keywords:
HirnabszessMorbus Osler-Weber-RenduStrokebrain abscesshereditary hemorrhagic telangiectasiahereditäre hämorrhagische Telangiektasiepulmonale arteriovenöse Malformationenpulmonary arteriovenous malformationsseptic embolismseptische Emboliestroke

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Area of Science:

  • Neurology
  • Vascular Medicine
  • Infectious Diseases

Background:

  • Hereditary hemorrhagic telangiectasia (HHT) is a genetic disorder affecting blood vessels.
  • Neurological complications in HHT can arise from arteriovenous malformations (AVMs).
  • Distinguishing between ischemic and infectious neurological events can be challenging.

Observation:

  • A patient with HHT presented with transient neurological symptoms suggestive of a transient ischemic attack (TIA).
  • The patient subsequently developed a convulsive event and fever, with initial MRI revealing a brain lesion with edema.
  • Differential diagnosis considered neoplasia due to the unusual edema, but further tests ruled this out.

Findings:

  • Follow-up MRI demonstrated septic embolisms and a brain abscess, indicating an infectious etiology.
  • The source of septic embolisms was identified as a pulmonary arteriovenous malformation (PAVM) associated with HHT.
  • Neurosurgical intervention and antibiotic therapy led to a favorable clinical outcome.

Implications:

  • This case highlights the importance of considering infectious etiologies, specifically brain abscesses, in HHT patients with neurological symptoms.
  • Early identification and management of PAVMs in HHT patients are critical to prevent serious neurological complications.
  • Integrated neurosurgical and infectious disease management is essential for successful treatment of brain abscesses secondary to HHT.