International medical case reports journal · 2025
A Rare Case of Ischemic Stroke Secondary to Polycythemia with Rapid Resolution After Phlebotomy.
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Hassan Adan Abdi, Jayte Mohamed, Kahie Feisal Dahir, Hirsi Abishir Mohamud
Аннотация
INTRODUCTION: Ischemic stroke secondary to polycythemia is a rare but serious complication, particularly in young adults. Early recognition and intervention can lead to rapid neurological recovery.
CASE PRESENTATION: A 21-year-old male from Western Uganda presented with sudden-onset right-sided hemiparesis and slurred speech. He had no prior history of thromboembolic events but reported chronic headaches and fatigue. Physical examination revealed facial asymmetry, right-sided weakness (power 3/5), and hyperviscosity signs. Laboratory tests confirmed polycythemia (Hb: 22 g/dL, Hct: 68%). Brain CT showed an acute left middle cerebral artery (MCA) infarct.
MANAGEMENT: Emergency phlebotomy (500 mL) was performed, followed by hydration and low-dose aspirin. The patient showed significant improvement within 48 hours, with near-complete resolution of symptoms at one-week follow-up.
CONCLUSION: Polycythemia-induced stroke, though rare, should be considered in young patients with unexplained thromboembolic events. Phlebotomy remains a rapid and effective treatment, especially in resource-limited settings.
CASE PRESENTATION: A 21-year-old male from Western Uganda presented with sudden-onset right-sided hemiparesis and slurred speech. He had no prior history of thromboembolic events but reported chronic headaches and fatigue. Physical examination revealed facial asymmetry, right-sided weakness (power 3/5), and hyperviscosity signs. Laboratory tests confirmed polycythemia (Hb: 22 g/dL, Hct: 68%). Brain CT showed an acute left middle cerebral artery (MCA) infarct.
MANAGEMENT: Emergency phlebotomy (500 mL) was performed, followed by hydration and low-dose aspirin. The patient showed significant improvement within 48 hours, with near-complete resolution of symptoms at one-week follow-up.
CONCLUSION: Polycythemia-induced stroke, though rare, should be considered in young patients with unexplained thromboembolic events. Phlebotomy remains a rapid and effective treatment, especially in resource-limited settings.