[Osler's disease--a risk factor for stroke].

BACKGROUND

Osler's disease is an inherited disease of blood vessels that causes haemorrhage from the nasal mucosa, gastrointestinal tract, lungs or the urinary tract. Patients may also have abnormal intracerebral vessels.

MATERIAL: A patient with Osler's disease and recurrent epistaxis suffered a cerebellar infarction. He had no other risk factors for stroke. An arteriovenous fistula was demonstrated in the right lung. This fistula was the probable source or aberrant pathway of an embolus to the cerebellum. The patient was treated with endovascular occlusion of the fistula to prevent further emboli to the brain.

INTERPRETATION: Embolisation of thrombi from arteriovenous fistulae in the lungs is a rare cause of stroke, though important since secondary prophylaxis is very effective. Physicians should consider this possibility in the occasional patient with embolic stroke in whom no other risk factor is established.