Keywords
cerebral infarction
thrombosis
arteriovenous fistula
How to Cite
Abstract
Cerebral ischemic infarction represents the majority of cerebrovascular events and is characterized by decreased cerebral blood flow resulting in cell death. Rendu-Osler-Weber syndrome or hereditary hemorrhagic telangiectasia, HHT, is an autosomal dominant genetic disease. It presents itself with arteriovenous malformations due to the expression of the affected gene on endothelial cells. This report describes the clinical case of a 44-year-old female with a history of chronic episodic headache with migraine characteristics since youth. She seeks medical attention due to sudden onset symptoms characterized by loss of balance, holocranial headache and hemiparesis of the left hemibody. In addition, it is documented that the patient made an airplane trip of more than 10 hours in duration, which favors thrombotic disease. Different radiological studies are carried out and the occlusion of the right middle cerebral artery, the right anterior cerebral artery and the left posterior cerebral artery is demonstrated. In addition, a cardiothoracic nuclear magnetic resonance reveals the presence of a pulmonary arteriovenous fistula. Fibrinolytic treatment with Alteplase is applied and a percutaneous embolization of the fistula is performed. The genetic study confirms the presence of HHT.
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