How to identify pediatric cerebral and pulmonary arteriovenous malformation earlier: non-hereditary hemorrhagic telangiectasia case
Cerebral and pulmonary arteriovenous malformations (AVMs) are well known respectively by doctors. However, there are few cases that a single patient suffers both cerebral AVM and pulmonary AVM. Hereditary hemorrhagic telangiectasia (HHT) is universally accepted as an autosomal dominant inherited disease, which represents telangiectasia is frequently multiple AVMs in internal organs. Very few non-HHT cases were diagnosed as cerebral and pulmonary arteriovenous malformations. We report one case with cerebral and pulmonary AVMs diagnosed as non-HHT to share our experience. This report aims to find the way of identifying non-HHT case with cerebral and pulmonary AVMs in early periods. To our knowledge, the primary goals in the treatment are early identification and intervention to prevent bleeding secondary to child cerebral hematoma. For these cases, systemic examination is necessary. If one child suffered cerebral hematoma and also suffers polypnea cyanosis and respiratory distress simultaneously, which indicates signs of oxygen deprivation, a pulmonary CT and brain CT should be performed without delay except for all efforts to diagnose cerebral AVM. All cases in childhood suffered cerebral hematoma and other systemic disorder, more detailed examination was necessary. Most cases were diagnosed as multiple AVMs. A cerebral digital subtraction angiography (DSA) and bronchoscope are necessary to reveal AVMs in the brain and lung.