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Cerebral embolism in a patient with polycythemia rubra vera
Author(s) -
Segura T.,
Serena J.,
Teruel J.,
Dávalos A.
Publication year - 2000
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1046/j.1468-1331.2000.00008.x
Subject(s) - medicine , transcranial doppler , stenosis , cardiology , embolism , magnetic resonance imaging , cerebral infarction , middle cerebral artery , magnetic resonance angiography , stroke (engine) , radiology , cerebral arteries , paradoxical embolism , cerebral angiography , angiography , ischemia , patent foramen ovale , percutaneous , mechanical engineering , engineering
Polycythemia rubra vera (PRV) is a rare haematological disorder that has a high risk of stroke, although the pathophysiological origin of the cerebral ischaemia in this disease is not well known. We report a case of a stroke patient with PRV in whom bilateral embolic signals were detected by transcranial Doppler (TCD). Cerebral computed tomography showed a cortical middle cerebral artery infarction, echocardiography was normal, duplex‐scan showed moderate left carotid stenosis and digital angiography disclosed right siphon stenosis. TCD examinations in the acute phase repeatedly showed a great number of bilateral microembolic signals (MESs). Four months later magnetic resonance angiography showed no flow signal in the right siphon and a severe stenosis of the proximal right MCA. The detection of bilateral MESs in the absence of cardiac sources of embolism observed in this patient suggests that ischaemic cerebral events in PRV may have an embolic origin favoured by a prothrombotic state.