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Cerebral Arteriovenous Fistula in Hereditary Hemorrhagic Telangiectasia

BLANKA SCHAUMANN, PhD; MILTON ALTER, MD, PhD
Am J Dis Child. 1973;126(4):563. doi:10.1001/archpedi.1973.02110190459026.
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To the Editor.—Recently, Boynton and Morgan1 described an infant with a positive family history of hereditary hemorrhagic telangiectasia (HHT) who died of congestive heart failure secondary to a large cerebral arteriovenous (AV) malformation. The authors believed their case was a unique instance of large cerebral AV malformation associated with HHT. However, other such cases have been reported previously2-4 and we have seen an additional example in a 46-year-old man with typical HHT, whose angiogram revealed a large AV malformation in the left frontal-parietal area and a smaller one in the right frontal pole. Cerebral vascular malformations of smaller and unspecified size have also been described in patients with HHT.5-10 In its relation to HHT, Boynton and Morgan's case was unusual only with respect to the early age at which the cerebral AV malformation manifested.

In view of the high frequency of neurological symptoms in HHT, such

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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