Highlights
- •First analysis of cerebrovascular disease (CVD) in Indian patients with polycythemia.
- •More than two-thirds of our sample had CVD. Most common type of CVD – large vessel occlusion, predominantly of the anterior circulation.
- •Multiple vessel stenoses and hyperdense vessels may be radiologic clues to polycythemia.
Abstract
Purpose
Patients with polycythemia, either primary or secondary, are at elevated risk for
thrombotic complications, including stroke. We aimed to investigate the clinical and
radiological characteristics of cerebrovascular disease (CVD) in polycythemia, and
describe other neurologic manifestations.
Methodology
We conducted a cross-sectional study of patients diagnosed with polycythemia between
2014 and 2019 at a tertiary care center and collected relevant medical data with a
special focus on cerebrovascular disease and neurologic manifestations. We performed
descriptive and inferential analyses. We have also described and analyzed the available
neuroimaging features.
Results
We analyzed data from 56 patients. 20 patients (35.7%) had ischemic stroke. The incidence
of CVD was higher in those with primary polycythemia (43%) than in those with secondary
polycythemia (8%). The most common subtype of stroke was large vessel disease, and
the most common arterial territory was the anterior circulation. There was no statistically
significant difference in the hematocrit level between those with or without CVD.
Neuroimaging revealed multiple large vessel intracranial stenoses on MR Angiography,
and hyperdense vessels on plain CT. Other neurologic manifestations included headache,
seizures, dizziness, visual symptoms and papilledema, and these were significantly
more common in primary polycythemia.
Conclusions
CVD is common in patients with polycythemia. The most common type observed was large
vessel occlusion, predominantly in the anterior circulation. In stroke patients, multiple
vessel stenosis and hyperdense vessels may be clues to polycythemia.
Key Words
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Article info
Publication history
Published online: November 13, 2021
Accepted:
October 6,
2021
Received in revised form:
October 1,
2021
Received:
September 3,
2021
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.106167
Copyright
© 2021 Elsevier Inc. All rights reserved.
