A Case of Severe Consciousness Disturbance Caused by Pulmonary Arteriovenous Malformation during Pregnancy

DOI 1 Citations 18 References
  • Tanaka Junya
    Shock Trauma Center, Dokkyo Medical University Koshigaya Hospital
  • Inoue Takuya
    Shock Trauma Center, Dokkyo Medical University Koshigaya Hospital
  • Sugiki Daisuke
    Shock Trauma Center, Dokkyo Medical University Koshigaya Hospital
  • Iwashita Hiroko
    Shock Trauma Center, Dokkyo Medical University Koshigaya Hospital
  • Yamada Kojiro
    Shock Trauma Center, Dokkyo Medical University Koshigaya Hospital
  • Miyanohara Toshio
    Shock Trauma Center, Dokkyo Medical University Koshigaya Hospital
  • Ikegami Keiichi
    Shock Trauma Center, Dokkyo Medical University Koshigaya Hospital

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  • 妊娠中に肺動静脈奇形により重篤な意識障害を来した１例

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Pulmonary arteriovenous malformation (PAVM) was diagnosed in a twenty-one-year-old woman when she was fifteen years old. Transcatheter embolotherapy had been performed repeatedly. Symptoms of bloody sputum, dyspnea, emotional instablility and muscular weakness of the lower limbs appeared during the second pregnancy. After considering the risks of radiological exposure, it was decided not to perform treatment for PAVM during pregnancy. Thereafter, similar symptoms persisted, and once the patient lost consciousness transiently, was diagnosed as having psychiatric disease, hospitalized and treated. About one month after the birth of the second baby, the patient suddenly fainted in a psychiatry hospital. She was transferred to our hospital due to consciousness disturbance of uncertain cause. On admission, her consciousness level was E2V2M4 (GCS). Brain MRI demonstrated cerebral infarction, and chest CT demonstrated PAVM. Intensive care for cerebral infarction was performed. Though consciousness level improved gradually to E4V4M6, she suddenly developed cardiopulmonary arrest 42 days after hospitalization, and died four days later. Pulmonary arteriovenous fistula deteriorates during pregnancy. When symptoms of breathing problems and consciousness disorder appear during pregnancy, it is necessary to investigate PAVM as a possible cause.

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