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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 20:1881-1884 (11 1999)
© 1999 American Society of Neuroradiology

ARTICLE

Transcranial Doppler of a Paradoxical Brain Embolism Associated with a Pulmonary Arteriovenous Fistula

Kazumi Kimura^,a, Kazuo Minematsu^a, Kuniyasu Wada^a, Masahiro Yasaka^a, Masafumi Tagaya^a, Sachio Kuribayashi^a and Takenori Yamaguchi^a

^a From the Cerebrovascular Division, Departments of Medicine (K.K., K.M., K.W., M.Y., M.T., T.Y.) and Diagnostic Radiology (S.K.), National Cardiovascular Center, Suita, Osaka, Japan.

Summary: We herein report the case of a patient who had paradoxical brain embolism owing to a pulmonary arteriovenous fistula (PAVF) who was diagnosed as having a right-to-left shunt by transcranial Doppler (TCD) with saline contrast medium. TCD with saline contrast medium failed to detect any high-intensity transient signals immediately after catheter embolization of the PAVF. Thus, TCD with saline contrast medium was useful for identifying the presence of a right-to-left shunt and for confirming that the shunt had been obliterated after endovascular treatment.

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