Repeated Ischemic Stroke due to in situ Thrombus at the Middle Cerebral Artery in a Patient with Essential Thrombocythemia

Intern Med. 2025 Jan 15;64(2):281-285. doi: 10.2169/internalmedicine.3590-24. Epub 2024 May 30.

Abstract

Essential thrombocythemia (ET) is a myeloproliferative neoplasm that is a rare cause of ischemic stroke. We herein report a 70-year-old man with JAK2 V617F mutation-positive ET who experienced ischemic stroke twice in 1 month due to transient stenosis. In both events, transient stenosis formed at the same curvature of the right middle cerebral artery, and the thrombus disappeared with the initiation of antiplatelet agents. The formation of in situ thrombus at the curvature of the intracranial vessels may be a unique characteristic of JAK2 V617F mutation-positive ET patients.

Keywords: essential thrombocytosis; in situ thrombus; ischemic stroke; neoplasm.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Humans
  • Intracranial Thrombosis* / complications
  • Ischemic Stroke* / etiology
  • Janus Kinase 2 / genetics
  • Male
  • Middle Cerebral Artery* / diagnostic imaging
  • Middle Cerebral Artery* / pathology
  • Platelet Aggregation Inhibitors / therapeutic use
  • Recurrence
  • Thrombocythemia, Essential* / complications
  • Thrombocythemia, Essential* / diagnosis
  • Thrombocythemia, Essential* / genetics
  • Thrombosis* / complications

Substances

  • Janus Kinase 2
  • JAK2 protein, human
  • Platelet Aggregation Inhibitors