TITLE:
Recurrent Ischemic Stroke Revealing Polycythemia Vera
AUTHORS:
Ndiaga Matar Gaye, Moussa Toudou-Daouda, Nicolas Chausson, Djibril Soumah, Nana Rahamatou Tassiou, Didier Smadja
KEYWORDS:
Ischemic Stroke, Acute Coronary Syndrome, Recurrence, Polycythemia Vera, Antiplatelet Therapy
JOURNAL NAME:
Neuroscience and Medicine,
Vol.13 No.1,
March
11,
2022
ABSTRACT: Background: Polycythemia vera is a possible cause of recurrent ischemic stroke which can be prevented. Aim: Describe a junctional ischemic stroke without large arterial trunks stenosis associated with an acute coronary syndrome. Case Presentation: A 66-years-old man was admitted for abrupt recurrent right hemiparesis related to bilateral and junctional ischemic stroke lesions. He had a medical history of a vertebrobasilar ischemic stroke concurrent with an acute coronary syndrome with normal coronary arteries. Transthoracic echocardiogram showed small apical akinesia. Hemoglobin level was 18.9 g/dl with a hematocrit of 57.6%. The endogenous erythropoietin was 1.3 mIU/ml with JAK2 V617F mutation positivity (37%). After eight months of treatment (hydroxycarbamide + aspirin + allopurinol) hemoglobin was 12.5 g/dL. Conclusion: This case illustrates the most suggestive features of PV particularly the ischemic stroke junctional topography.