nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2023-6-78-84nnp-2142Research ArticleCLINICAL OBSERVATIONSКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯA rare cause of stroke at a young age: ischemic stroke by the mechanism of paradoxical embolism in a patient with hereditary hemorrhagic telangiectasiaРедкая причина инсульта в молодом возрасте: ишемический инсульт по механизму парадоксальной эмболии у пациента с наследственной геморрагической телеангиэктазиейhttps://orcid.org/0000-0003-3124-2443БелопасоваА. В.BelopasovaA. V.

Анастасия Владимировна Белопасова

125367, Москва, Волоколамское шоссе, 80

Anastasia Vladimirovna Belopasova

80, Volokolamskoe Sh., Moscow 125367

belopasova@neurology.ruhttps://orcid.org/0009-0002-4181-7730ШлапаковаП. С.ShlapakovaP. S.

125367, Москва, Волоколамское шоссе, 80

80, Volokolamskoe Sh., Moscow 125367

https://orcid.org/0000-0001-9929-2725ДобрынинаЛ. А.DobryninaL. A.

125367, Москва, Волоколамское шоссе, 80

80, Volokolamskoe Sh., Moscow 125367

https://orcid.org/0000-0001-7491-7215КадыковА. С.KadykovA. S.

125367, Москва, Волоколамское шоссе, 80

80, Volokolamskoe Sh., Moscow 125367

Институт клинической и профилактической неврологии ФГБНУ «Научный центр неврологии»РоссияInstitute of Clinical and Preventive Neurology, Research Center of NeurologyRussian Federation2023161220231567884Copyright © Belopasova A.V., Shlapakova P.S., Dobrynina L.A., Kadykov A.S., 20232023Белопасова А.В., Шлапакова П.С., Добрынина Л.А., Кадыков А.С.Belopasova A.V., Shlapakova P.S., Dobrynina L.A., Kadykov A.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/2142

Clarification of the aetiology of ischemic stroke (IS) in young adults (aged between 18 and 45 years) is an extremely difficult task, as rare causes that are hardly known to neurologists are very common. One of these causes is paradoxical embolism due to pulmonary arteriovenous malformation (AVM), one of the manifestations of hereditary hemorrhagic telangiectasia (HHT). The diagnosis of HHT-associated pulmonary AVMs and IS is a multistep task that requires a personalized multidisciplinary approach using high-tech ultrasound, tomographic and genetic examination methods. This article discusses the clinical case of a young patient with HHT and recurrent IS through the mechanism of paradoxical embolism from pulmonary AVMs; issues of diagnosis, treatment and prevention of both the underlying disease and recurrent vascular events are discussed.

Уточнение этиологии ишемического инсульта (ИИ) в молодом возрасте (от 18 до 45 лет) является крайне сложной задачей из-за высокой частоты редких причин, мало знакомых неврологам. В числе таких причин парадоксальная эмболия из легочной артериовенозной мальформации (АВМ) – одного из проявлений наследственной геморрагической телеангиэктазии (НГТ). Диагностика НГТ-ассоциированных легочных АВМ и ИИ – многоэтапная задача, требующая персонализированного мультидисциплинарного подхода с проведением высокотехнологичных ультразвуковых, томографических и генетических методов обследования. В статье рассматривается клинический случай пациента молодого возраста с НГТ, повторными ИИ по механизму парадоксальной эмболии из легочных АВМ; обсуждаются вопросы диагностики, лечения и профилактики как основного заболевания, так и повторных сосудистых событий.

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The authors declare that there are no conflicts of interest present.