Cerebral Symptoms in Pulmonary Arteriovenous Fistula

Abstract

Two cases of pulmonary arteriovenous fistulas with hemiparesis and other neurologic findings, possibly from paradoxical embolization, are described. Many theories have been put forward to explain the pathophysiology of the frequently present neurologic manifestations. We regard paradoxical embolization through the fistula as the most important factor in the pathogenesis of the neurologic deficit. Due to the potential hazard of paradoxical cerebral embolization and possible subsequent brain abscess formation, surgical resection of all pulmonary arteriovenous fistulas wherever feasible is recommended.