A Case of Multiple Cerebral Infarcts Due to Severe Anemia Preceded by Migraine-like Headache with Aura

We herein report a 47-year-old woman who developed migraine-like headache with aura and subsequent multiple cerebral infarcts, likely due to severe iron deficiency anemia (IDA) from menorrhagia. The progression from IDA to ischemic stroke involves several pathophysiological mechanisms, including red...

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Bibliographic Details
Published in:Internal Medicine 2024, pp.3842-24
Main Authors: Oryu, Kiichiro, Kato, Yuji, Mochizuki, Yoshiki, Arai, Noriko, Deguchi, Ichiro, Takahashi, Shinichi, Suda, Satoshi
Format: Article
Language:English
Subjects:
iron deficiency anemia
ischemic stroke
migraine with aura
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Summary:We herein report a 47-year-old woman who developed migraine-like headache with aura and subsequent multiple cerebral infarcts, likely due to severe iron deficiency anemia (IDA) from menorrhagia. The progression from IDA to ischemic stroke involves several pathophysiological mechanisms, including reduction of erythrocyte deformability, reactive thrombocytosis, and anemic hypoxia. We speculate that a microembolus first caused cortical spreading depression without infarcts and that a larger thromboembolus then caused multiple infarcts. This case highlights the transition from migraine-like headache to ischemic stroke. New-onset migraine-like headache is a warning of impending ischemic stroke, and IDA may be a potential underlying cause.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.3842-24