Cerebrovascular Complications and Polycythaemia Vera

Excerpt

Polycythaemia vera (PV) is a stem cell-derived myeloid haematologic malignancy. It is characterized by an expansion of one or more haematopoietic cell lineages, resulting in increased mature blood components in the peripheral blood. The disease features include erythrocytosis, leukocytosis and/or thrombocytosis, as a consequence of which PV may exhibit a unique prothrombic state [1, 2]. There is a possibility of progression into acute myeloid leukaemia or myelofibrosis, the 10-year risk ranging between 3% and 10%, but the life expectancy of patients with PV is commonly affected by thrombo-haemorrhagic events, with a reported incidence of 12–39% [1, 3]. The clinical manifestations of the thrombotic events in PV patients may vary from mild microvascular circulatory disturbances (e.g. erythromelalgia, tinnitus or vertigo) to more severe complications, such as migraine-like cerebral transient ischaemic attacks, transient ischaemic attacks, ischaemic stroke, myocardial infarction or venous thrombosis (e.g. cerebral sinus and venous thrombosis or deep venous thrombosis). Information relating to the association of PV and cerebrovascular complications such as stroke and transient ischaemic attacks from detailed clinical aspects are limited in the relevant literature [4‐7]. …