Iron deficiency anemia: Is it a benign disease? A case report

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Ling Jyh Chyang, Siti Nur Hajar Mohd Zain, Mohamad Hidir Abdullah and Ng Wei Chih

Sibu Hospital, Malaysia

: J Spine Neurosurg

Abstract

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We report a case of a 27 year old lady with underlying Iron Deficiency Anemia (IDA), who developed acute right Middle cerebral artery (MCA) territory ischemic infarct. She presented with sudden onset of left-sided hemiplegia associated with facial asymmetry, slurring of speech and headache 2 days after undergoing caesarean section. She appeared pale, lethargic and on further inspection showed koilonychia on both hands. At presentation her hemoglobin (4.9 g/dL), mean corpuscular volume (65.1 fL) and hemoglobin (19.2 pg) were low. A Computed Tomography (CT) brain scan on admission showed acute infarct over right MCA territory. CT angiography brain was done to rule out thromboembolic cause of stroke, results were negative. Echocardiogram was negative for thrombus and no carotid artery stenosis or thrombus seen on ultrasound of carotid arteries. Her neurological deficits gradually improved with transfusion of packed red blood cells, correction of her anemia. Iron deficiency anemia as a risk for stroke could be explained via three mechanisms: (1) Thrombocytosis, (2) hyper-coagulable state and (3) anemic hypoxia. Iron deficiency anemia is often overlooked as a benign disease, which if not treated promptly could lead to severe morbidity or life threatening large cerebral hemispheric infarction.

Biography

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Jyh Chyang Ling is being currently working as a Neurosurgeon in Neurosurgery Department Sibu Hospital, Malaysia. His research Interest is being currently focussed on Neurosurgery, Neuro endoscopy, Neurology.

E-mail: gchyang@gmail.com