Pulmonary arteriovenous fistulae thrombosis responsible for recurrent stroke

Pathophysiological mechanisms of ischaemic strokes occurring in patients with Rendu-Osler-Weber (ROW) disease remain unclear. We report on the case of a patient with ROW disease and pulmonary arteriovenous fistula thrombosis who suffered from recurrent strokes. In January 2005, a 38 year old woman was referred for the first time to our hospital for an ischaemic stroke fifteen days after undergoing a medically induced abortion. She reported recurrent epistaxis during her two pregnancies (1993 and 1994) and two familial cases of Rendu-Osler-Weber (ROW) disease. She also had experienced two episodes of ischaemic stroke (January 1996 and December 1997). Stroke workup had only revealed a patent foramen ovale with atrial septal aneurysm, which had been surgically closed after the second stroke. She had been receiving aspirin since closure of the foramen ovale. Eight years after the procedure, she presented with a new ischaemic stroke in the right middle …