Progressive Middle Cerebral Artery Infarction in a Patient with Thrombotic Thrombocytopenic Purpura |
Sang Wook Ha, Bong Goo Yoo, Min Jeong Kim, Jong Kuk Kim, Kwang Soo Kim |
Department of Neurology, Kosin University College of Medicine, Busan, Korea. ybgne@ns.kosinmed.or.kr |
진행성 중대뇌동맥 경색을 보인 혈전성 혈소판감소성 자반증 |
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Abstract |
Thrombotic thrombocytopenic purpura (TTP) is frequently associated with small cortical and subcortical infarcts. However, major intracranial artery occlusion is rare. We report a case of progressive middle cerebral artery (MCA) infarction in a patient with TTP. A 76-year-old woman with hypertension was admitted due to right hemiparesis and transcortical motor aphasia. On laboratory findings, she had microangiopathic hemolytic anemia and thrombocytopenia. Brain MRI showed left subcortical multiple infarction, and MR angiogram revealed severe stenosis of left MCA main stem. She was treated with heparin and steroid but a few days later, there was neurologic deterioration attributed to progressive occlusive stroke in the left MCA territory. Follow-up brain CT demonstrated left malignant MCA infarction. TTP may be associated with progressive occlusion of large cerebral artery. |
Key Words:
Thrombotic thrombocytopenic purpura, Middle cerebral artery infarction, Stenosis |
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