Stroke in a young female

Abstract

A 30-year-old female, with no prior co-morbidities, presented with chief complaints of headache for 4 days, deviation of the angle of the mouth towards the right side for 4 days, vomiting for 1 day and altered sensorium for 1 day. On general physical examination, her vitals were normal. Her Glasgow Coma Scale was E4V5M6. Neurological examination showed left-sided hemiplegia and left facial palsy. Diffusion-weighted imaging–magnetic resonance imaging was suggestive of acute infarct. Complete haemogram showed anaemia, thrombocytopenia; leucocytosis with 60% promyelocytes. Diagnosis of acute promyelocytic leukaemia was made. The patient was started on injection arsenic trioxide. However, the patient lapsed into a deep coma and started to bleed in the form of ecchymotic patches. Non-contrast computed tomogram brain was suggestive of right capsuloganglionic bleed with midline shift coagulation profile suggested of disseminated intravascular coagulation. The patient later succumbed to death.

Keywords

• acute infarct in the right temporoparietal region
• acute promyelocytic leukaemia
• arsenic trioxide
• disseminated intravascular coagulation
• right capsuloganglionic bleed