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Letter to the Editor

https://doi.org/10.21857/m8vqrtgzx9

JAK 2 mutation positive polycythemia vera presenting as internal carotid artery dissection followed by dural sinus thrombosis

Miljenko Crnjaković ; Department of Neurology, University Hospital Dubrava, Zagreb, Croatia
Gorana Vukorepa ; Department of Neurology, KlinikLandstrasse, Wien, Austria,
Sabina Deveđija ; Department of Neurology, University Hospital Dubrava, Zagreb, Croatia *

* Corresponding author.


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Abstract

Polycythemia vera is a stem cell disorder, often complicated by thrombotic and hemorrhagic events.
We report a case of polycythemia vera in a 60-years-old man which presented with acute ischemic
stroke. Computed tomography angiography of head and neck vessels was perfomed which revealed left
internal carotid artery dissection. During his hospitalization his neurological status deteriorated and
brain MRI, MRA and MRV showed right internal jugular vein, superior sagittal, sigmoid and transverse
sinus thrombosis with hemorrhage in left frontal and parietal lobe. Repeated laboratory evaluation
showed slightly elevated platelets and hematological consultation was requested. Results of sternal
puncture suggested myeloproliferative disorder and JAK2 mutation was positive. Thrombus formation
in the dural sinus is extremely rare in PV patients. To best of our knowledge this is the first case describing
occurence of acute ischemic stroke, internal carotid artery dissection and dural sinus thrombosis
in PV patient. It highlights the need of awareness of the association of PV and cerebrovascular disease
and PV should be considered as a part of the differential diagnosis in patient with acute cerebrovascular
event of otherwise unknown origin.

Keywords

Polycythemia vera, JAK 2 mutation, dural sinus thrombosis

Hrčak ID:

312723

URI

https://hrcak.srce.hr/312723

Publication date:

22.12.2023.

Visits: 460 *