Mehta Preema J, Chapman Sherita, Jayam-Trouth Annapurni, Kurukumbi Mohankumar
Department of Neurology, Howard University Hospital, 2041 Georgia Ave., Washington, DC 20060, USA.
Case Rep Neurol Med. 2012;2012:487080. doi: 10.1155/2012/487080. Epub 2012 May 9.
A rare case of acute ischemic stroke in a young patient with iron deficiency anemia (IDA) is reported. IDA has been suggested to have an association with stroke, but few cases have proven it thus far. Three physiological mechanisms explaining IDA to ischemic stroke include a hypercoagulable state secondary to IDA, thrombocytosis secondary to IDA, and anemic hypoxia induced by IDA. Our paper shows an example of a hypoxia-induced stroke secondary to IDA in a young woman with menorrhagia. Thrombus formation was ruled out as the Magnetic Resonance Angiogram (MRA) showed no evidence. As all other known causes for stroke were ruled out, the patient's IDA is a reasonable cause for her stroke. Iron deficiency decreases the amount of hemoglobin, which consequently decreases the amount of oxygen in the blood resulting in low-oxygen delivery to the brain. This causes hypoxic conditions in the brain, leading to death of brain tissue. Thus, we suggest a possible relationship between IDA and ischemic stroke in young adults. Considering IDA as one of the risk factors for ischemic stroke and treating with timely transfusions would be an important step one can take to prevent stroke.
本文报告了一例年轻缺铁性贫血（IDA）患者发生急性缺血性卒中的罕见病例。已有研究表明IDA与卒中有关，但迄今为止，仅有少数病例能证实这一点。三种解释IDA与缺血性卒中关系的生理机制包括：IDA继发的高凝状态、IDA继发的血小板增多症以及IDA诱导的贫血性缺氧。我们的论文展示了一名患有月经过多的年轻女性因IDA继发缺氧性卒中的病例。磁共振血管造影（MRA）显示无血栓形成迹象，排除了血栓形成的可能。由于排除了所有其他已知的卒中病因，患者的IDA是其卒中的合理病因。缺铁会减少血红蛋白的量，进而降低血液中的氧气含量，导致大脑的氧输送不足。这会在大脑中造成缺氧状态，导致脑组织死亡。因此，我们认为IDA与年轻成年人的缺血性卒中之间可能存在关联。将IDA视为缺血性卒中的危险因素之一，并及时进行输血治疗，是预防卒中的重要措施。
