Clinical features of ischemic stroke and transient ischemic attack associated with suspicious pulmonary arteriovenous fistula detected only by transesophageal echocardiography
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- KURIKI Ayako
- Department of Neurology, Showa University Kototoyosu Hospital
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- KATOU Hirotaka
- Department of Neurology, Showa University
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- MIZUMA Keita
- Department of Neurology, Showa University Kototoyosu Hospital
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- SAITO Yu
- Department of Neurology, Showa University
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- KAMIYA Yuki
- Department of Neurology, Showa University Kototoyosu Hospital
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- KAWAMURA Mitsuru
- Department of Neurology, Showa University
Bibliographic Information
- Other Title
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- 経食道心エコーのみで肺動静脈瘻が疑われた脳梗塞と一過性脳虚血発作19例の臨床的特徴
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Abstract
Background: Suspected pulmonary arteriovenous fistula (PAVF) on transesophageal echocardiography (TEE) is sometimes difficult to prove with examinations such as contrast-enhanced (CE) CT. <br>Methods: Clinical features were investigated in 19 patients with ischemic stroke (14 men; mean age, 60.8 y) with suspected PAVF on TEE but unproven on further examinations. Patients with atrial fibrillation, aortic atherosclerosis, ipsilateral carotid or intracranial stenosis and other risks of stroke such as vasculopathies, hypercoagulable states, or hematologic disorders were excluded. <br>Results: The infarct region was in the territory of the unilateral middle cerebral artery in 12 cases, bilateral in 1 case, posterior cerebral artery in 1 case, vertebrobasilar artery in 2 cases, internal carotid artery in 1 case, and undetermined in 2 cases. CECT was performed in 17 cases (including 3D CT reconstruction in 7 cases), ventilation/perfusion lung scintigraphy in 1 case, and CE-MRI in 1 case. Modified Rankin Scale (mRS) scores at discharge were 0, 1, 2 and 3 in 7, 6, 1 and 4 cases, respectively, and 4 in a case complicated by Wernicke's encephalopathy. In 2 cases in which PAVF was proven on CECT, the mRS scores were 2 and 5. <br>Conclusion: Patients with unproven PAVF tended to have better outcomes than those with proven PAVF. Patients with unproven PAVF may have small PAVFs or shunts unrelated to stroke that still require comprehensive treatment due to other risks and pathologies.
Journal
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- Neurosonology
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Neurosonology 28 (3), 134-138, 2015
The Japan Academy of Neurosonology
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Details 詳細情報について
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- CRID
- 1390001204420892032
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- NII Article ID
- 130005124619
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- ISSN
- 18843336
- 0917074X
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- Text Lang
- ja
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- Data Source
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- JaLC
- Crossref
- CiNii Articles
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- Abstract License Flag
- Disallowed