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Updated: Jul 23, 2025
A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
Hyperprolactinemia-induced acute ischemic stroke
Zane Elfessi1, Danielle Dressler2, Sara Johnson3
1Department of Emergency Medicine, Jesse Brown Veterans Affairs Medical Center, 820 S Damen Avenue, Chicago, IL 60612, United States of America; University of Illinois-Chicago College of Pharmacy, Department of Pharmacy Practice, 833 S Wood Street, Chicago, IL 60612, United States of America.
Insights
This case study highlights a rare instance of acute ischemic stroke (AIS) in a young male with hyperprolactinemia. It underscores the potential link between elevated prolactin levels and stroke risk, especially with medication non-compliance.
Area of Science:
- Neurology
- Endocrinology
- Cardiovascular Medicine
Background:
- Strokes are a leading cause of death, with ischemic strokes being the most common type.
- Platelet activation is crucial in thrombus formation, traditionally linked to factors like thromboxane A2 and thrombin.
- Hormonal influences on platelet activation, such as by prolactin, are an emerging area of research.
Observation:
- A 25-year-old male with a history of pituitary microadenoma and hyperprolactinemia presented with an acute ischemic stroke.
- The patient's stroke occurred in the context of non-compliance with prescribed medication.
Findings:
- This case represents the first documented instance of acute ischemic stroke in a patient with known hyperprolactinemia who experienced a stroke due to medication non-compliance.
- The findings suggest a potential association between hyperprolactinemia and increased stroke risk, particularly when hormonal regulation is compromised.
Implications:
- This case emphasizes the importance of considering hormonal imbalances, like hyperprolactinemia, in the etiology of ischemic stroke, even in young patients.
- It highlights the critical role of medication adherence in managing conditions associated with hormonal dysregulation and preventing cerebrovascular events.
- Further research is warranted to elucidate the precise mechanisms by which prolactin influences platelet activation and contributes to stroke risk.
Abstract:
Strokes are the fifth leading cause of death in the United States with almost 800,000 patients seeking emergency care each year-most of whom are seen for ischemic strokes. Acute ischemic strokes (AIS) can be caused by emboli in diseases such as atrial fibrillation as well as thrombus formation in the form of platelet deposition in patients with atherosclerotic disease. Platelet activation by immunomodulators including thromboxane A2 (TXA2), serotonin, and thrombin have been extensively delineated; however, the activation by hormones such as prolactin has only recently been revealed. We present a case of a 25-year-old male with a history of pituitary microadenoma and hyperprolactinemia who presented with an acute ischemic stroke in the setting of medication non-compliance. To our knowledge, this is the first known case of AIS in a patient with known hyperprolactinemia who presented with a stroke due to be medication non-compliance.
