Published online Sep 6, 2021. doi: 10.12998/wjcc.v9.i25.7551
Peer-review started: February 28, 2021
First decision: July 5, 2021
Revised: July 12, 2021
Accepted: July 19, 2021
Article in press: July 19, 2021
Published online: September 6, 2021
Processing time: 183 Days and 10.7 Hours
Polycythemia vera (PV) is a chronic myeloproliferative disorder characterized by an increase in red blood cells in the peripheral blood. Previous work has reported the occurrence of thrombosis or hemorrhage arising in the cerebral vasculature secondary to PV. However, hemorrhagic transformation after PV-associated acute ischemic stroke has not been previously described.
We herein present two cases of PV where hemorrhagic transformation occurred after an acute ischemic stroke. Case 1 was a 57-year-old woman with a history of hypertension who was admitted for left-sided weakness. Case 2 was a 68-year-old man who was admitted for a 10-d sudden left arm weakness. Imaging examinations for the two patients revealed hemorrhagic transformation after acute ischemic stroke. Both patients had JAK-2-V617F mutation and received antiplatelet therapy. Both of them had a good prognosis during the follow-up.
This report suggested that hemorrhagic transformation may occur in acute ischemic stroke caused by PV. Antiplatelet drugs do not seem to influence the long-term outcomes in such patients. Future research should focus on establishing a standard antiplatelet treatment strategy for this condition.
Core Tip: Polycythemia vera (PV) is a rare, myeloproliferative disorder. Ischemic stroke is the most frequent neurologic manifestation of PV. However, hemorrhagic transformation after acute ischemic stroke caused by PV has not been previously reported. Here, we present two patients with PV who developed hemorrhagic transformation after sustaining an acute ischemic stroke. Antiplatelet drugs did not lead to poor long-term outcomes in our patients.