Radiological features and outcomes of essential thrombocythemia-related stroke

Essential thrombocythemia (ET) is known to be associated with an increased vascular event, but the stroke patterns and prognosis have not been studied.

Between January 2013 and December 2017, acute ischemic stroke patients with ET who were admitted to two tertiary hospital stroke centers in Seoul, Korea were included. We retrospectively reviewed their clinical, laboratory and imaging data. Stroke mechanism was determined as ET-only when no atherosclerotic, cardioembolic, or lacunar stroke etiology was demonstrated and as ET-plus group when any specific etiology was combined. Each group was analyzed to ascertain stroke patterns and outcomes.

A total of 26 patients were included, and their mean age was 66 ± 17 years, including 12 female patients. There were 12 ET-only cases and 14 ET-plus cases per stroke mechanism. The ET-plus group included 7 large artery atherosclerosis, 5 small vessel occlusion, and 2 cardioembolic cases. Multiple scattered lesions involving multiple vascular territories were more prevalent in the ET-only group. Poor outcome (modified Rankin scale >2 at discharge) was noted in 13 cases (50.0%), and old age, female sex, prior diagnosis of ET to stroke and low hemoglobin level were associated with poor outcome.

ET-related stroke displayed a characteristic infarction pattern, such as multiple embolisms.