Concurrent Ruptured Pseudoaneurysm of the Internal Carotid Artery and Cerebral Infarction as an Initial Manifestation of Polycythemia Vera

Abstract

The most common neurologic manifestations of polycythemia vera (PV) are cerebral infarction and transient ischemic attacks, while cerebral hemorrhage or intracranial dissection has been rarely associated with PV. Here we report the first case of a 59-year-old patient with intracranial supraclinoid internal carotid artery (ICA) dissection causing cerebral infarction and concomitant subarachnoid hemorrhage due to pseudoaneurysm rupture as clinical onset of PV. This case report discusses the possible mechanism and treatment of this extremely rare condition.

Acquired von willebrand syndrome in patients with philadelphia-negative myeloproliferative neoplasm

“…The platelet counts of ET patients with AVWS were higher than those without. However, the difference was not significant (949.7±440.0×10 9 /L and 813.7±170.7×10 9 /L; P=0.205). The positivity for JAK2V617F positivity and the burden of alleles did not differ between the two groups.…”

“…Three patients with ET had VWF:RCo ＜30% at the time of diagnosis. These patients had significantly higher platelet counts than those with VWF:RCo ≥30% (1,228.3±824.8×10 9 /L and 837.8±228.8×10 9 /L; P=0.037) (Table 3). Patients with PV with AVWS (N=3) had sig-Ik-Chan Song, et al nificantly higher platelet counts than those without AVWS (N=14) (1,120.7±671.7×10 9 /L and 510.0±206.7×10 9 /L; P=0.009).…”

“…AVWS has rarely been addressed in Korean patients with Ph -MPN. Only one case of AVWS has been reported in a patient with PV [9]. In 2020, the Korean Society of Hematology revised the guidelines for diagnosing and managing MPN based on published evidence and the experience of an expert panel.…”

Multifocal cerebral haemorrhage in two dogs with erythrocytosis

“…The exact mechanism of the haemorrhagic event remains unclear; however, it was speculated that an increase of circulating platelets might result in an increased absorption of von Willebrand factor multimers in the platelet membranes 34,35 . Other hypotheses include vessel rupture secondary to distension or ischaemia 36–38 …”

“…34,35 Other hypotheses include vessel rupture secondary to distension or ischaemia. [36][37][38] The second dog was presumptively diagnosed with secondary erythrocytosis causing extensive cerebral haemorrhage. The secondary erythrocytosis was believed to be due to bilateral nephropathy.…”