Clinical features of bilateral multiple pulmonary arteriovenous fistulas with paroxysmal aphasia as the first symptom: a case report

Abstract

Objective: to describe the clinical features of bilateral multiple pulmonary arteriovenous fistulas(PAF) with paroxysmal aphasia as the first symptom. Methods: we collected the clinical history and examination data of a patient with paroxysmal aphasia. In order to trace the etiology, we performed chest computed tomography(CT) and pulmonary CT angiography (CTA). Results: the patient had paroxysmal aphasia with dizziness, brain magnetic resonance imaging(MRI) showed cerebral infarction, the transcranial Doppler(TCD) foaming test was positive, transesophageal ultrasound showed no patent foramen ovale, and chest CT and CTA showed bilateral multiple PAF. Conclusion: bilateral multiple PAF are rare in clinic. When patients have paroxysmal neurological symptoms, the possibility of PAF leading to embolism should be considered.

Keywords

aphasia / pulmonary arteriovenous fistula(PAF) / cerebral embolism / transcranial Doppler(TCD) foaming test