Aortic Runoff as a Sign of Intracranial Arteriovenous Malformation: Report of Two Cases
An 11-day-old female newborn was referred to us with the diagnosis of cardiomyopathy. She was born by cesarian section and discharged from nursery in good condition. Four days later she was visited by pediatrician because of jaundice, he noticed cardiac murmur and severe cardiomegaly on chest x-ray and referred her to our hospital for more cardiac evaluation by initial diagnosis of cardiomyopathy at the age of 11 days ().\nOn physical examination she had tachypnea (60/min), tachycardia (160/min), and grade 3/6 systolic cardiac murmur, loud second heart sound and continuous murmur over skull. Precise echocardiography revealed right to left shunt via PFO and small PDA and reduced cardiac ejection fraction. Brachiocephalic arteries were dilated and there was retrograde aortic runoff in descending thoracic aorta in diastole. There was no PDA, AP window and no aortic regurgitation so she was highly suspicious of cranial AV fistula. More diagnostic evaluation by brain sonography and CT scanning confirmed the diagnosis. Transcatheter embolization of afferent arteries for this patient was successful. Now, after 6 months follow up baby is in good condition with normal cardiac function and no neurologic complication ().