1. Ischemic Stroke as the First Manifestation of Hepatic Epithelioid Hemangioendothelioma
- Author
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Dimitrios Kravaritis, Avraam Assi, Panagiotis Zis, and Vassilios A. Sevastianos
- Subjects
Adult ,Image-Guided Biopsy ,medicine.medical_specialty ,Pathology ,medicine.medical_treatment ,Neurological examination ,Brain Ischemia ,Liver Function Tests ,Predictive Value of Tests ,Risk Factors ,Vertigo ,medicine ,Humans ,Thrombophilia ,International Normalized Ratio ,Obesity ,Blood Coagulation ,Past medical history ,medicine.diagnostic_test ,biology ,business.industry ,Liver Neoplasms ,Rehabilitation ,biology.organism_classification ,Magnetic Resonance Imaging ,Stroke ,Liver Lobe ,Liver biopsy ,Vomiting ,Hemangioendothelioma, Epithelioid ,Abnormal Liver Function Test ,Female ,Surgery ,Cholecystectomy ,Neurology (clinical) ,Radiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
A 38-year-old obese woman, with a past medical history of cholecystectomy and dyslipidaemia, presented with acute occipital headache, vomiting and rotational vertigo which lasted 8 hours. On admission neurological examination was unremarkable, however general physical examination revealed hepatomegaly. Routine blood tests showed abnormal liver function tests. MRI scan indicated an acute ischemic infarct in the right cerebellum. Extensive investigation was negative. However, liver MRI revealed multiple lesions in both liver lobes. Ultrasound guided liver biopsy and histopathological analysis confirmed the diagnosis of hepatic hemangioendothelioma. In conclusion, hypercoaguable state related to hepatic epithelioid hemangioendothelioma can lead to an ischemic stroke, as a rare first manifestation of the disease.
- Published
- 2014
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