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Successful thrombolysis in essential thrombocythemia-related acute ischaemic stroke
  1. Ishita Desai,
  2. Ashutosh Tiwari,
  3. Mritunjai Kumar Singh and
  4. Niraj Kumar
  1. Neurology, All India Institute of Medical Sciences - Rishikesh, Rishikesh, Uttarakhand, India
  1. Correspondence to Dr Niraj Kumar; drnirajkumarsingh{at}


Essential thrombocythemia (ET)-related acute ischaemic stroke (AIS) may account for approximately 0.25%–0.5% of all ischaemic strokes. If left undiagnosed and untreated, patients with ET carry an increased risk of recurrent thrombosis involving major organs including the brain. We report an interesting case of a 67-year-old man, who was successfully thrombolysed for AIS resulting from ET. He presented with sudden onset of left-sided hemiparesis with a left-ventricular clot. His subsequent investigations including positive JAK2 V617F mutation confirmed the diagnosis of ET. He made a significant recovery with thrombolysis, anticoagulation, antiplatelet and hydroxyurea. A fear of post-thrombolytic haemorrhagic complications appears the major reason for the lack of reports of thrombolysis in ET-related AIS. Although the diagnosis of ET was confirmed on subsequent investigations, successful thrombolysis in our case provides preliminary evidence that ET-related AIS cases can undergo successful thrombolysis using tenecteplase. To date, ours is only the second case of ET-related AIS being thrombolysed.

  • stroke
  • drugs: CNS (not psychiatric)
  • neurology

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  • Contributors ID: conception, design and writing the first manuscript. AT, MKS and NK: review and critique.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.