Risk factors of ischemic stroke/transient ischemic attack in young women: A case report
DOI:
https://doi.org/10.51248/.v41i1.555Keywords:
Lacunar stroke, ischemic stroke, oral contraceptive, circle of Willis, hypoplasiaAbstract
This case report aims to demonstrate the clinical significance of the left internal carotid artery (ICA) hypoplasia in a young woman who received a combined oral contraceptive (COC) and its association with arterial occlusion and the development of a lacunar stroke/lacunar cerebral infarct (LACI). Brain magnetic resonance imaging (MRI) of the left frontal lobe revealed multiple subcortical and periventricular amplification/ischemia foci (49.0×17.0 mm), and lacunar infarct loci (2.0×4.0 mm). Brain magnetic resonance angiography revealed a markedly narrowed lumen of the left ICA (2.0–3.0 mm). MRI diffusion-weighted imaging-fluid attenuated inversion recovery revealed a moderate diffuse wall thickening and reinforcement of the left ICA. The patient was diagnosed with LACI and congenital hypoplasia of the left ICA and underwent antiplatelet drug therapy (aspirin - 100 mg) and a complete withdrawal of COC. A full amelioration of neurological symptoms was observed after one month of treatment.
References
Ahmed, S. B., Hovind, P., Parving, H-H., Rossing, P., Price, D. A., Laffel, L. M., et al., Oral contraceptives, angiotensin-dependent renal vasoconstriction, and risk of diabetic nephropathy. Diabetes Care. 2005; 28(8): 1988-1994.
Chan, W. S., Ray, J., Wai, E. K., Ginsburg, S., Hannah, M. E., Corey, P. N., et al., Risk of stroke in women exposed to low-dose oral contraceptives: a critical evaluation of the evidence. Arch Intern Med. 2004; 164(7): 741-747.
Ciccone, A., Melis, M. Ischemic stroke risk in oral contraceptive users. Stroke. 2003; 34(12): e231.
Gillum, L. A., Mamidipudi, S. K., Johnston, S. C. Ischemic stroke risk with oral contraceptives: A meta-analysis. JAMA. 2000; 284(1): 72-78.
Chen, C. J., Chen, S. T., Hsieh, F. Y., Wang, L. J., Wong, Y. C. Hypoplasia of the internal carotid artery with intercavernous anastomosis. Neuroradiology. 1998; 40(4): 252-254.
Gunawansa, N. Hypoplastic Ipsilateral Internal Carotid Artery as a Cause of Acute Ischemic Stroke: A Case Report. World J Surg Surgical Res. 2018; 1: 1060.
Roach, R. E., Helmerhorst, F. M., Lijfering, W. M., Stijnen, T., Algra, A., Dekkers, O. M. Combined oral contraceptives: the risk of myocardial infarction and ischemic stroke. Cochrane Database Syst Rev. 2015; 2015(8): CD011054.
Staikov, I., Stoyanov, I., Staneva, M., Neykov, N., Kirova, G., Polomski, P., et al. Diagnostic value of color-coded duplex sonography in patients with ischemic stroke and congenital changes in the circle of Willis. Cor et Vasa. 2016; 58(6): e591-e599.
Mujagi?, S., Kozi?, D., Huseinagi?, H., Smajlovi?, D. Symmetry, asymmetry and hypoplasia of the intracranial internal carotid artery on magnetic resonance angiography. Acta Med Acad. 2016; 45(1): 1-9.
Wassertheil-Smoller, S., Hendrix, S. L., Limacher, M., Heiss, G., Kooperberg, C., Baird, A., et al. Effect of estrogen plus progestin on stroke in postmenopausal women: The Women's Health Initiative: a randomized trial. JAMA. 2003; 289(20): 2673-2684.
Kemmeren, J. M., Tanis, B. C., van den Bosch, M. A., Bollen, E. L., Helmerhorst, F. M., van der Graaf, Y., et al. Risk of Arterial Thrombosis in Relation to Oral Contraceptives (RATIO) study: oral contraceptives and the risk of ischemic stroke. Stroke. 2002; 33(5): 1202-1208.
Lidegaard, O., Kreiner, S. Contraceptives and cerebral thrombosis: a five-year national case-control study. Contraception. 2002; 65(3): 197-205.
Lidegaard, O. Smoking and use of oral contraceptives: impact on thrombotic diseases. Am J Obstet Gynecol. 1999; 180(6 Pt 2): S357-S363.
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