[Recurring ischemic cerebral infarction caused by primary thrombocytosis in infancy]

Ischemic cerebrovascular disease includes a set of entities that are produced by disorders in components of the blood, the blood flow, the walls of blood vessels or the heart, and can be anatomical, functional or even mixed.

We describe the case of an 18-month-old male patient with compensated celiac disease, with repeated ischemic strokes in different territories, including the right posterior cerebral artery and middle cerebral artery, in the course of a hypercoagulable state due to essential thrombocytosis. Computerised axial tomography scans, brain angioresonance, a complete blood chemistry analysis and bone marrow biopsy were all performed and confirmed the previous diagnosis. Exchange transfusion, antiplatelet drugs and a platelet production inhibitor (anagrelide) were begun as therapy. At present, the patient is 2 years old and still has a slight direct hemiparesis, which is complete and predominantly faciobrachial, with no alterations to language.

Cerebral infarctions in infancy are infrequent, and their presentation obliges the attending clinician to seek causes that are not usual. In our patient the hypocoagulability came about due to essential thrombosis, which is rare in infancy. The cause behind the infarction determines the chances of its recurring. Acetylsalicylic acid did not prove to be effective for this purpose. We suggest using carbamazepine for the treatment of kinesigenic dystonias.