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(Stroke. 2008;39:e38.)
© 2008 American Heart Association, Inc.

Letters to the Editor

Vertebral Artery Occlusion After Chemotherapy

Guillermina García Martín, MD

Neurology Department, Virgen de la Victoria Hospital, Malaga, Spain

Susana Puerta Fernández, MD

Internal Medicine Department, Virgen de la Victoria Hospital, Malaga, Spain

Vicente Serrano Castro, MD; Omar Hamad Cueto, MD Manuel Romero Acebal, MD

Neurology Department, Virgen de la Victoria Hospital, Malaga, Spain

An extract of the first 250 words of the full text is provided, because this article has no abstract.

To the Editor:

We have read the interesting report by Periard et al about cisplatin-induced strokes.¹ The role of tumors as risk factors for vascular disorders has long been established. However, there is little evidence regarding the effects of chemotherapy. Several reports describe vascular toxicity in young patients treated with cisplatin, and these studies suggest a casual link.^2,3

We present a patient who experienced a stroke due to vertebral artery occlusion after chemotherapy.

A 48-year-old female patient was admitted to our hospital with nausea, vomiting, and headache. The patient also complained of tingling in the left side of her face. She had previous history of ovarian thecoma that was treated surgically on 3 occasions because of relapse and was finally treated with chemotherapy. The first dose of cisplatin, etoposide, and bleomycin was given 4 days before admission.

On admission she presented with Horner syndrome, facial asymmetry, impaired elevation of the left soft palate and dysfonia. She also had dismetria in left arm. Her gait deviated to the left side.

Blood tests were unremarkable, except for low leukocyte levels, with low neutrophyle level, which was related to the side effects of chemotherapy, as levels returned to normal in posterior tests without specific treatment. The MRI showed brain damage in the left occipital region, left cerebellum hemisphere, and left thalamus compatible with acute ischemic stroke in the vertebral-basilar territory. MRI angiography showed obstructed flow in the left vertebral artery with no other abnormalities. Thrombophilia-autoimmunity screening, syphilis, and HIV tests, ECG, echocardiogram, cerebral . . . [Full Text of this Article]

Related Article:

Response to Letter by García Martín et al

Daniel Periard, Stephan Eyer, Chantal M. Boulanger, Mahmut Ozsahin, and Daniel Hayoz
Stroke 2008 39: e39. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				D. Periard, S. Eyer, C. M. Boulanger, M. Ozsahin, and D. Hayoz Response to Letter by Garcia Martin et al Stroke, February 1, 2008; 39(2): e39 - e39. [Full Text] [PDF]