International Journal of Research and Reports in Hematology

Ischemic Stroke in a Young Adult Patient: Excess of Factor VIII

W. Machrouh *

M. A. Fehdi

Polyvalent Intensive Care Unit, Ibn Rochd University Hospital, Casablanca, Morocco and Casablanca Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.

Y. Hafiani

Polyvalent Intensive Care Unit, Ibn Rochd University Hospital, Casablanca, Morocco and Casablanca Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.

A. Nsiri

Polyvalent Intensive Care Unit, Ibn Rochd University Hospital, Casablanca, Morocco and Casablanca Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.

R. AlHarrar

Polyvalent Intensive Care Unit, Ibn Rochd University Hospital, Casablanca, Morocco and Casablanca Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.

H. Kouame

Casablanca Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco and Biological Hematology Department, Ibn Rochd University Hospital, Casablanca, Morocco.

H. Bencharef

Casablanca Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco and  Biological Hematology Department, Ibn Rochd University Hospital, Casablanca, Morocco.

B. Oukkache

Casablanca Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco and Biological Hematology Department, Ibn Rochd University Hospital, Casablanca, Morocco.

*Author to whom correspondence should be addressed.

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Abstract

Aims: Ischemic stroke in young adult patients is an increasing public health problem. Hypercoagulability states and thrombophilia are both rare conditions behind ischemic strokes in young patients. We report a case of ischemic stroke in a young patient due to an excess of factor VIII.

Presentation of Case: A 38-year-old woman with a medical history of depression treated with Clomipramine was admitted to the emergency room for coma. The initial brain CT-Scan showed an image of a spontaneously hyper dense basilar artery, and brain MRI found a right occipital and left capsule-thalamic ischemic stroke with total occlusion of the basilar arterial trunk. A standard biological assessment has been performed showing an isolated elevation of factor VIII level at 200%.

Discussion: Approximately 80% of all strokes are ischemic strokes. Thrombophilic disorders and their contribution to the stroke risk are uncommon and factor V Leiden mutation accounts for almost half of the thrombophilic states. Case-control studies have suggested an association between elevated levels of FVIII and cryptogenic stroke in particular, which was nearly four times higher in people with elevated FVIII.

Conclusion: Factor VIII excess is a recently described, apparently common, and under-recognized cause of hypercoagulability. This case should make consider the fact that ischemic stroke is not only a pathology of the old subject. Also, it highlights the implication of excess in factor VIII in the states of hypercoagulability as a cause of young patient’s ischemic stroke.

Keywords: Ischemic stroke, Factor VIII excess, young patient, thrombophilia

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Author Biography

W. Machrouh

Polyvalent Intensive Care Unit, Ibn Rochd University Hospital, Casablanca, Morocco and Casablanca Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.

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