Novel Partial Anomalous Pulmonary Venous Connection Associated with Brain Abscess
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Background Right-to-left vascular shunts are associated with brain abscess. Case Report We present a 47-year-old female with a cryptogenic left thalamic abscess onwhich Streptococcus mitis grew upon aspiration. Computed tomography of the chest with contrast agent revealed an anomalous connection between the left superior pulmonary and brachiocephalic veins. A right-to-left shunt was confirmed in a transthoracic echocardiogram study in which bubbles were injected into the left arm; this shunt had not previously been noted uponright-arm injection. Conclusions We recommend aggressive evaluation for right-to-left shunts in patients who present with cryptogenic brain abscesses. In addition to imaging, this should include a bubblebased study with left-arm saline injection.
Abstract
Background Right-to-left vascular shunts are associated with brain abscess. Case Report We present a 47-year-old female with a cryptogenic left thalamic abscess onwhich Streptococcus mitis grew upon aspiration. Computed tomography of the chest with contrast agent revealed an anomalous connection between the left superior pulmonary and brachiocephalic veins. A right-to-left shunt was confirmed in a transthoracic echocardiogram study in which bubbles were injected into the left arm; this shunt had not previously been noted uponright-arm injection. Conclusions We recommend aggressive evaluation for right-to-left shunts in patients who present with cryptogenic brain abscesses. In addition to imaging, this should include a bubblebased study with left-arm saline injection.
참고문헌 (15)
- Kawamata T, "Patent foramen ovale as a possible risk factor for cryptogenic brain abscess: report of two cases", Neurosurgery, 49, pp.204~206 (2001)
- Hirth A, "Brain abscess associated with an unusual cause of right to left shunt", Heart, 93, pp.34~ (2007)
- Mathisen GE, "Brain abscess", Clin Infect Dis, 25, pp.763~779 (1997)
- Sung CW, "Brain abscess in an adult with atrial septal defect.", Clin Cardiol, 33, pp.E51~E53 (2010)
- Trerotola SO, "PAVM embolization: an update", AJR Am J Roentgenol, 195, pp.837~845 (2010)
- Whitfield P, "The management of intracranial abscesses", Adv Clin Neurosci Rehabil, 5, pp.12~15 (2005)
- Aebi C, "Brain abscess in childhood--longterm experiences", Eur J Pediatr, 150, pp.282~286 (1991)
- Takeshita M, "Risk factors for brain abscess in patients with congenital cyanotic heart disease", Neurol Med Chir (Tokyo), 32, pp.667~670 (1992)
- Moussouttas M, "Pulmonary arteriovenous malformations: cerebral ischemia and neurologic manifestations", Neurology, 55, pp.959~964 (2000)
- Troost E, "Percutaneous closure of a persistent left superior vena cava connected to the left atrium", Int J Cardiol, 106, pp.365~366 (2006)
- Mahadevan G, "Echocardiography in cryptogenic cerebrospinal abscess", J Am Soc Echocardiogr, 21, pp.401~403 (2008)
- Kaiser LR, "Mastery of Cardiothoracic Surgery" (2006), Lippincott Williams & Wilkins
- Walsh R, "Hurst’s the Heart" (2011), McGraw-Hill
- Singh S, "Anomalous connection of superior vena cava to the left atrium masquerading as epilepsy: a case report with review of literature", Ann Card Anaesth, 11, pp.42~45 (2008)
- Walder LA, "Pulmonary arteriovenous malformations with brain abscess", Am Heart J, 127, pp.227~232 (1994)