Brain abscess as the first clinical manifestation of multiple pulmonary arteriovenous malformations in a patient with hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber disease).

In this report we described a case of a cerebral abscess that developed in presence of asymptomatic pulmonary arteriovenous malformations (PAVMs) in a 53-year-old woman with hereditary hemorrhagic telangiectasia (HHT). The brain abscess was aspirated with good clinical result and the arteriovenous fistulae qualified for transcatheter embolotherapy. Each patient suspected to suffer from HHT should be diagnosed for the presence of visceral vascular malformations. Most of them are found in the lungs, liver and brain. Early diagnosis and treatment of PAVM prevent the occurrence of severe neurological complications such as brain stroke or brain abscess. Cases of a cerebral abscess in adults of unexplained etiology should raise the suspicion of an asymptomatic PAVM.