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Neurol Sci. 2008 Jun;29(3):169-71. doi: 10.1007/s10072-008-0930-5. Epub 2008 Jul 9.

Paradoxical brain embolism in a young man with isolated pulmonary arteriovenous fistula.

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  • 1UO Neurologia, Azienda Ospedaliera-Universitaria, Verona, Italy.


We herein report a case of ischemic stroke due to paradoxical brain embolism in a young man, a trumpet player. Extensive diagnostic investigations revealed the presence of an isolated pulmonary arteriovenous fistula as the only risk factor for stroke. The peculiarity of this case is the early onset of neurological symptoms in the absence of Hereditary Hemorrhagic Teleangiectasia. The Authors suppose the repeated Valsalva maneuvers as a possible factor promoting fistula enlargement and symptoms development.

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