A patient with cerebral arteriovenous malformation and multiple metallic pulmonary particles.

teriovenous malformation was diagnosed 19 years earlierwhen seizures occurred. She was initially treated with carbamazepine, phenytoin, and phenobarbital. A few years later a right hemiparesis developed, which subsequently improved with treatment. One year be¬ fore admission, again a progression of the hemiparesis was noticed. Otherwise, the patient's medical history did not disclose any other abnormalities. At the time of admission, the patient was in good health. The vital signs were normal. The physical examination of the chest was within normal limits. Except for a partial right hemiparesis the other physical findings were normal. All the laboratory data were within normal limits. The ECG was noncontributory. A posteroante¬ rior chest roentgenogram disclosed randomly distrib¬ uted, equally sized spheres (1 mm in diameter) of metallic density throughout both lungs (Fig 1).