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October 1987

Computed Tomographic Evidence of Cerebral Focal Ischemic Lesion in Thrombotic Thrombocytopenic Purpura

Author Affiliations

Department of Neurology
Department of Second Internal Medicine St Maria delle Croci Hospital Via Missiroli 10 48100 Ravenna, Italy

Arch Neurol. 1987;44(10):996. doi:10.1001/archneur.1987.00520220006003

To the Editor.   —Thrombotic thrombocytopenic purpura (TTP) is a potential but infrequent cause of cerebral ischemia in young adults.1 In a recent survey of 144 young patients with nonhemorrhagic cerebral infarction,2 no cases of TTP are reported. Computed tomographic (CT) evidence of cerebrovascular damage in TTP is extremely rare.3

Report of a Case.  —We recently admitted a 27-year-old woman because of recurrent attacks of right-sided central facial palsy (five in 36 hours), accompanied by slight fever. When she was not experiencing the attacks, her neurologic examination was normal. An electroencephalogram showed an excess of theta activity in the left frontotemporal regions. An electrocardiogram was normal. Blood parameters revealed severe hemolytic anemia (hemoglobin concentration, 57 g/L [5.7 g/dL], corrected reticulocyte count, 0.15 [15%]), severe thrombocytopenia (platelet count, 20 X 106/L [20 000/mm3]), and mild disseminated intravascular coagulation (DIC) (fibrinogen level, 1.25 g/L [125 mg/dL];

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