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Hemorrhagic Stroke in a 24-Year-Old Male With Polycythemia Vera: A Case Report and Literature Review
Josephine M Rivera1, Paul Vincent Opinaldo2
1Adult Neurology, Quirino Memorial Medical Center, Quezon City, PHL.
Insights
This case study highlights a young hypertensive patient who experienced a pontine hemorrhage, revealing an underlying diagnosis of Polycythemia Vera (PV). PV contributes to bleeding and hypertension, increasing stroke risk.
Area of Science:
- Neurology
- Hematology
Background:
- Stroke is a leading global cause of death.
- Intracerebral hemorrhage is a significant stroke type in young adults.
- Hypertension is a primary cause of hemorrhagic stroke.
Abstract:
Stroke is the second leading cause of death worldwide, according to the latest report by the World Health Organization (WHO). Intracerebral hemorrhage comprises 20-25% of the stroke in the young, with incidence rates of three to six in 100,000 people per year. One of the most common and important causes of hemorrhagic stroke in the general population is hypertension. Polycythemia vera (PV) can manifest with both cranial thrombosis and hemorrhage. We report a 24-year-old male, known hypertensive, who presented as a pontine hemorrhage. Further examination with imaging and laboratory tests demonstrated a diagnosis of PV. In PV, platelet dysfunction and acquired Von Willebrand syndrome are predisposing factors to bleeding. Associated blood viscosity and the proinflammatory state cause vascular remodeling, leading to hypertension. These mechanisms have collectively been described to cause hemorrhagic stroke in PV.
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