Journal
NEUROLOGICAL SCIENCES
Volume 44, Issue 5, Pages 1765-1768Publisher
SPRINGER-VERLAG ITALIA SRL
DOI: 10.1007/s10072-023-06671-6
Keywords
Cervical artery dissection; Hemophilia; Neck trauma; Antithrombotic drugs
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Spontaneous cervical artery dissection (sCeAD) is the most common cause of ischemic stroke at a young age. Hemophilia A, an X-linked condition that leads to spontaneous bleeding, may also be associated with arterial dissection. However, the relationship between these two diseases and the best antithrombotic treatment option for hemophilia patients with arterial dissection have not been studied extensively.
Spontaneous cervical artery dissection (sCeAD) is the most common cause of ischemic stroke at a young age, but its pathogenetic mechanism and risk factors are not fully elucidated. It is reasonable to think that bleeding propensity, vascular risk factors such as hypertension and head or neck trauma, and constitutional weakness of the arterial wall together play a role in the pathogenesis of sCeAD. Hemophilia A is known to be an X-linked condition that leads to spontaneous bleeding in various tissues and organs. To date, a few cases of acute arterial dissection in patients with hemophilia have been reported, but the relationship between these two diseases has not been studied so far. In addition, there are no guidelines indicating the best antithrombotic treatment option in these patients. We report the case of a man with hemophilia A who developed sCeAD and transient oculo-pyramidal syndrome and was treated with acetylsalicylic acid. We also review previous published cases of arterial dissection in patients with hemophilia, discussing the potential pathogenetic mechanism underlying this rare association and potential antithrombotic therapeutic options.
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