Neurological Sciences

, Volume 31, Issue 3, pp 341–343

Paradoxical brain embolism caused by an arterial−venous fistula: a diagnostic pitfall

  • Piergiorgio Lochner
  • Frediano Tezzon
  • Rafaelle Nardone
  • Christian Tanislav
Case Report


The transesophageal echocardiography (TEE) and contrast-enhanced transcranial Doppler/Duplex ultrasonography (ceTCD) are complementary methods for diagnosing a right to left shunt across a patent foramen ovale. We report on a case of paradoxical embolism across a subclavian arterial–venous fistula. This case underlines the necessity of performing the ceTCD, as in this condition the right to left shunt could be detected by means of ceTCD, whereas the TEE reveals regular findings.


Patent foramen ovale Arterial–venous fistula Paradoxical embolism Transesophageal echocardiography Contrast-enhanced transcranial Doppler/Duplex ultrasonography 


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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Piergiorgio Lochner
    • 1
  • Frediano Tezzon
    • 2
  • Rafaelle Nardone
    • 2
  • Christian Tanislav
    • 1
  1. 1.Department of NeurologyUniversity Hospital GiessenGiessenGermany
  2. 2.Department of NeurologyFranz Tappeiner HospitalMeranItaly

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