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Atrioesophageal fistula

Atrioesophageal fistula (AEF) is a rare complication of cardiac ablation for atrial fibrillation. It can present in many ways, but neurological signs and symptoms are common initial signs sometimes resulting in neurosurgeons and neurologists first evaluating patients with the condition. We present a case report of at 68-year-old female who presented with acute stroke symptoms and multifocal hemorrhages on MRI who was worked up through our neurosurgery department and diagnosed with AEF. This case highlights three clues to alert neurological clinicians to AEF as a possible diagnosis; clinical worsening of neurological symptoms in correlation to episodes of emesis, septic emboli on CT/MRI, and bacteremia caused by a gram positive oral or GI flora. If neurological clinicians encounter these red flags, an immediate CT of the chest and abdomen and consultation with cardiothoracic surgery may be life-saving 1).

Atrioesophageal fistula: a rare cause of brain embolization 2).

Zima LA, Fornoff LE, Surdell DL. Atrioesophageal Fistula: Considerations for the neurological clinician. Clin Neurol Neurosurg. 2018 Jul;170:58-60. doi: 10.1016/j.clineuro.2018.04.029. Epub 2018 Apr 27. PubMed PMID: 29730269.
Mrackova J, Rohan V, Geier P, Burianek V, Mracek J. Atrioesophageal fistula: a rare cause of brain embolization. Acta Neurol Belg. 2018 Aug 18. doi: 10.1007/s13760-018-1005-x. [Epub ahead of print] PubMed PMID: 30121813.
atrioesophageal_fistula.txt · Last modified: 2018/08/20 20:11 by administrador