RT Journal Article
SR Electronic
T1 Midbrain infarction in inherited protein S deficiency: a rare association
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e246073
DO 10.1136/bcr-2021-246073
VO 14
IS 10
A1 Manali Chandra
A1 Atanu Chandra
A1 Sayantan Chakraborty
A1 Joydeep Ghosh
YR 2021
UL http://casereports.bmj.com/content/14/10/e246073.abstract
AB Inherited thrombophilic disorders are well‐established predisposing factors for venous thromboembolism, but their role in arterial ischaemic stroke is uncertain. The exact mechanism of arterial thrombosis in thrombophilias remains elusive. Herein, we report a case of a 30-year-old woman who was admitted to our facility with sudden-onset right-sided ptosis and ophthalmoplegia. Detailed clinical features, neuroimaging and laboratory evaluation clinched the diagnosis of ischaemic stroke in midbrain due to microvascular obstruction associated with isolated protein S deficiency. She was treated with oral anticoagulant (warfarin) and physiotherapy; without any improvement of her symptoms at 2 months of follow-up. A high index of clinical suspicion is needed in any case of young ischaemic stroke in absence of common cardiac and vascular risk factors, to recognise the presence of inherited thrombophilia.