Abstract

ALET, Matías J.; BERTONI, Hernán  and  AMERISO, Sebastián F.. Ischemic stroke due to paradoxical embolism through pulmonary arteriovenous malformation in a young patient. Medicina (B. Aires) [online]. 2024, vol.84, n.2, pp.351-355. ISSN 0025-7680.

Paradoxical embolism due to an isolated pulmonary arteriovenous malformation (PAVM) is a rare cause of ischemic stroke. PAVMs are abnormal high-flow connec tions between pulmonary arteries and veins, diverting deoxygenated blood into the systemic circulation and they represent a less common source of paradoxical embolisms, especially in young individuals. Endovascular embolization is the preferred treatment for clinically significant PAVMs.

We present the case of a 34-year-old woman with a left thalamic ischemic stroke. Severe contrast passage was detected in cerebral arteries through transcranial Doppler. Intracardiac ultrasound did not reveal a patent foramen ovale, prompting further investigation with pulmonary CT angiography, confirming the presence of PAVM. The patient underwent successful endovascular treatment.

It is essential to consider PAVM in the etiological di agnosis of ischemic stroke, especially in young patients with signs of abnormal right-to-left communication. Periodic follow-up imaging is recommended to assess potential recurrence or changes in PAVM, emphasizing the importance of appropriate management of these malformations.

Keywords : Ischemic stroke; Young patient; Paradoxi cal embolism; Pulmonary arteriovenous malformation.

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