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Clinical and Radiological Profile of Cerebrovascular Disease in Polycythemia: Analysis of Neurologic Manifestations from a Tertiary Center in South India

      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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