Etiology and treatment of ischaemic stroke in patients with β-thalassemia major.

BACKGROUND AND PURPOSE: Although hypercoagulability-induced thromboembolism is generally accepted as cause of cerebral ischaemia in thalassemic patients, cardiogenic embolism has been recently suggested as another possible stroke etiology.

METHODS

We present four adult β-thalassemia major patients with manifest cardiac involvement who suffered territorial strokes.

RESULTS

In the presence of siderotoxic cardiomyopathy and arrhythmia, we assumed cardiogenic embolism as etiology of stroke and initiated oral anticoagulation as preventive medication. Two of our patients were the first β-thalassemia major patients who underwent successful thrombolysis with rtPA.

CONCLUSIONS

Cardioembolism seems to be the cause of stroke in cases of β-thalassemia major. Thrombolysis can be applied in the setting of acute brain ischaemia in such high risk patients.