Cardioembolic stroke revealed by increased hemostatic markers associated with intracardiac thrombus

The presence of hemocoagulative disorders in acute ischemic stroke has been reported occasionally. However, the cause of the hemostatic derangement has not been fully elucidated.

A 66-year-old woman with a history of hypertension and myocardial infarction developed pure motor hemiparesis. On admission, she was thought to have a lacunar infarction. However, computed tomography of the brain with contrast medium revealed a small infarct in the cortex of the frontal lobe. Conventional angiography showed no stenotic or occlusive lesions. Sensitive hemocoagulative tests revealed hypercoagulative and hyperfibrinolytic states. Ultrafast computed tomography of the heart with contrast enhancement demonstrated a large left ventricular mural thrombus. There were no further abnormal findings suggestive of other systemic diseases that affect blood coagulability. As a result, the patient was diagnosed as having suffered a cardioembolic stroke.

An intracardiac thrombus could be one of the causes of the hemostatic disorders of acute cardioembolic stroke.