Abstract Details

Title Imaging Characteristics of Ischemic Stroke Associated to Iron Deficiency Anemia

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P06 - (-)

Poster/Presentation
Number 264

Objective

Background BACKGROUND: At our institution, we have identified group of patients with AIS and severe IDA without identifiable stroke etiology. In the pediatric literature, severe IDA has been associated with AIS in otherwise healthy children. The hypothesized mechanism is reactive thrombocytosis and florid inflammatory cascade leading to venous and/or arterial occlusion.

Design/Methods DESIGN/METHODS: From our stroke registry, AIS patients with Hct <28% from July 2004 through March 2012 was identified. Retrospective chart analysis was performed to select severe IDA patients defined by Hgb <10 g/dL with MCV <75 fL or ferritin <15 mcg/L or transferrin saturation <5%. Demographics, laboratory data, and clinical course were obtained. Brain MRI, CTA, and/or MRA images were reviewed when available along with neuro-radiologist's report. DWI lesion(s) were classified as single or multiple, and the involved location and vascular territory were gathered.

Results RESULTS: Among 4,477 AIS patients, 39 met criteria for severe IDA of which 14 were deemed cryptogenic. Median age was 44 (±5.2); median Hgb 7.1 (±1.4) and Hct 23.7 (±4.2). 13 patients had MRI brain and 1 was ineligible; 92% had DWI lesions that were multiple and supratentorial. Vessel imaging showed 6 with intracranial occlusion ipsilateral to the stroke, 2 Moya-moya physiology, and 1 venous occlusion contralateral to the stroke side.

Conclusions CONCLUSIONS: Imaging associated with cryptogenic AIS in the setting of IDA is heterogeneous. However, we observed a pattern of multiple DWI positive lesions among this group of patients, which may support embolic phenomena. However, due to small number of subjects, further studies are needed to support this finding.

Authors/Disclosures
Ellie E. Choi, MD (Overlake Neuroscience Institute) PRESENTER	No disclosure on file
	No disclosure on file
Nicole Gonzales, MD (University of Colorado Anschutz Medical Campus)	The institution of Dr. Gonzales has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology.
	No disclosure on file

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