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Open Access Case report

Stroke in hereditary hemorrhagic telangiectasia patients. New evidence for repeated screening and early treatment of pulmonary vascular malformations: two case reports

Espartaco Ribeiro1*, Julien Cogez1, Emmanuel Babin2, Fausto Viader1 and Gilles Defer1

Author Affiliations

1 Service de Neurologie, Centre Hospitalier Universitaire Côte de Nacre, 14033 cedex 9, Caen, France

2 Service d'Oto-Rhino-Laryngologie, Centre Hospitalier Universitaire, Caen, France

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BMC Neurology 2011, 11:84  doi:10.1186/1471-2377-11-84

Published: 9 July 2011

Abstract

Background

Paradoxical embolism due to pulmonary arteriovenous malformations is the main mechanism of brain infarction in patients with hereditary hemorrhagic telangiectasia. International Guidelines have recently been published to clarify the performance of screening tests and the effectiveness of treatment for pulmonary arteriovenous malformations.

Case Presentation

We present two cases of hereditary hemorrhagic telangiectasia patients of our hospital who experienced an acute stroke secondary to paradoxical embolism.

Conclusions

These two cases show that the guidelines must be followed to prevent the occurrence of ischemic stroke in patients with hereditary hemorrhagic telangiectasia, and that although they may be adequate in most cases, there are some patients who need a more personalized approach.