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Multiple cerebral infarctions associated with ovarian hyperstimulation syndrome.
F Yoshii1, N Ooki, Y Shinohara
1Department of Neurology, Tokai University School of Medicine, Isehara, Japan. yoshii@is.icc.u-tokai.ac.jp
Neurology
|July 17, 1999
Summary
Ovarian hyperstimulation syndrome (OHSS) can lead to serious brain issues like cerebral infarction. Prompt recognition of neurological symptoms is crucial in patients with OHSS to prevent severe outcomes.
Area of Science:
- Reproductive Endocrinology
- Neurology
- Hematology
Background:
- Human menopausal gonadotropin-human chorionic gonadotropin (hMG-hCG) therapy is used for infertility treatment.
- Ovarian hyperstimulation syndrome (OHSS) is a potential complication of such therapies.
- Cerebral infarction is a serious neurological event.
Observation:
- A 26-year-old woman undergoing hMG-hCG therapy developed multiple cerebral infarctions.
- The patient presented with symptoms consistent with OHSS.
- Neurological deficits were noted in association with the thromboembolic events.
Findings:
- The cerebral infarctions were linked to a hypercoagulable state.
- Laboratory findings included hemoconcentration, elevated D-dimer and thrombin-antithrombin III complex, and reduced protein S activity.
- These hematological changes indicate an increased risk of blood clot formation.
Implications:
- OHSS can precipitate thromboembolic events, including cerebral infarction.
- Mild neurological deficits in OHSS patients may be subtle and easily missed.
- Increased awareness and vigilant neurological monitoring are essential for patients with OHSS, especially those undergoing fertility treatments.