Pulmonary and Cerebral Arteriovenous Fistula With Osler's Disease

VASCULAR anomalies of the skin and visceral organs occurring in families have been described under a multiplicity of titles, eponyms, and syndromes. As medical knowledge of these conditions became more widespread and as the recognition of these particular disease processes became more obvious, there was an increase in the number of cases reported in the literature. This also brought to light that the seemingly unrelated independent disease processes apparently were related embryologically, anatomically, and genetically. Hereditary hemorrhagic telangiectasia has been described by many authors, but the three most frequently associated with this process are Rendu, Osler, and Weber. Many studies reported in recent years about families with this vascular abnormality have presented the fact that pulmonary arteriovenous (abbreviated to "AV") fistula is an integral part of this disease. About 50% of the cases of pulmonary AV fistula have hereditary hemorrhagic telangiectasia.1-4The pulmonary lesions may take the forms