Brain Perfusion Computed Tomography Findings of Cerebral Infarction associated with Polycythemia Vera

Abstract

Background:Polycythemia vera (PV) is a myeloproliferative stem cell disorder which increases the risk of ischemic stroke. We evaluated an ischemic stroke patient with PV using serial perfusion computed tomography (PCT). Case Report: A 48-year-old female presented with intermittent right upper extremity weakness for 2 months and speech disturbance for 1 month. Precontrast brain CT did not reveal any ischemic areas but mean transit time (MTT) map of PCT showed decreased perfusion in left temporo-occipital areas. MR angiography was normal. Ischemic lesions on diffusion-weighted MRI were mismatched compared to MTT map of PCT. After treatment with aspirin and serial phlebotomy, her aphasia was partially improved. After treatment with alkylating agent, hypoperfusion areas on PCT were more decreased than before. Conclusion:Improvement of brain perfusion may be delayed without normalization of hematologic abnormality in an ischemic stroke patient with PV. PCT is a useful method for assessing ischemic stroke in PV.

Keywords

• Polycythemia vera
• Cerebral infarction
• Aphasia
• Perfusion CT