Repeated cerebral hemorrhage in multiple lobes of the brain of a 38 year-old female patient with polycythemia vera: Case report and literature review

Abstract

BackgroundPolycythemia vera (PV) is a BCR-ABL1-negative myeloproliferative neoplasm characterized by an elevated red blood cell count and an increased risk of thrombosis and bleeding. Currently, there are only a few reports of recurrent hemorrhage in various brain lobes of PV patients, with no such reports involving young PV patients. Here we report a rare case of a young female patient with PV suffered from repeated cerebral hemorrhage. Case descriptionA 38-year-old female patient with PV, came to our hospital due to headache and hemiplegia. Following a computed tomography (CT) scan, it was discovered that the patient was experiencing bleeding in the right frontal lobe. On the third day of admission, CT scans revealed increased bleeding in the right frontal lobe and new bleeding in the left frontal lobe. We will perform right frontal lobe hematoma removal and decompressive craniectomy without delay. On the fourth day following the operation, the CT scan revealed increased bleeding in the left frontal lobe, along with a small amount of new bleeding in the right frontal and parietal lobes. Therefore, we conducted surgery to remove the hematoma from the patient's left frontal lobe and also performed a left decompressive craniectomy. Over the course of a month, her vital signs steadily stabilized and her consciousness slowly improved, progressing from a coma to drowsiness as treatment continued. ConclusionsPV patients exhibit a high risk of bleeding tendency when compared to normal individuals. PV patients who present with splenomegaly, thrombocytopenia, and a history of bleeding require additional attention to bleeding tendency.