Clinical and Neuroimaging Patterns of Ischemic Stroke in Ph-negative Myeloproliferative Neoplasms

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Abstract

Introduction. Philadelphia-negative myeloproliferative neoplasms (MPNs) are a rare blood disorder characterized by pancytosis and thrombohemorrhagic complications.

The aim of this article is to describe clinical and neuroimaging patterns of brain changes in patients with MPN.

Materials and methods. The study included 152 patients with an established diagnosis of MPN (according to WHO criteria 2008, 2016). A clinical and neurological examination, laboratory tests, and magnetic resonance imaging of the brain were performed.

Results. In patients with polycythemia vera and primary myelofibrosis, neuroimaging patterns are represented by small (up to 1.5 cm) post-infarction lesions in the brainstem, cerebellum, and cortex in adjacent perfusion territories after hemorheological microocclusive stroke. In patients with essential thrombocythemia, the neuroimaging pattern is more often represented by massive post-infarction changes in cortical-subcortical brain tissue with atherosclerotic lesions of the major head arteries, which appear to be atherothrombotic. Stroke preceded hematologic diagnosis in 30% of polycythemia vera cases, 40% of essential thrombocythemia cases, and 25% of primary myelofibrosis cases.

About the authors

Мarine М. Tanashyan

Research Center of Neurology

Email: mtanashyan@neurology.ru
ORCID iD: 0000-0002-5883-8119

Dr. Sci. (Med.), Professor, Corr. Member of the Russian Academy of Sciences, Deputy Director of science, Head, 1st Neurological department, Institute of Clinical and Preventive Neurology

Russian Federation, Moscow

Polina I. Kuznetsova

Research Center of Neurology

Author for correspondence.
Email: angioneurology0@gmail.com
ORCID iD: 0000-0002-4626-6520

Cand. Sci. (Med.), researcher associate, 1st Neurological department, Institute of Clinical and Preventive Neurologyt

Russian Federation, Moscow

Anton A. Raskurazhev

Research Center of Neurology

Email: rasckey@live.com
ORCID iD: 0000-0003-0522-767X

Cand. Sci. (Med.), senior researcher associate, 1st Neurological department, Institute of Clinical and Preventive Neurology

Russian Federation, Moscow

Anait L. Melikyan

National Research Center for Hematology

Email: anoblood@mail.ru
ORCID iD: 0000-0002-2119-3775

Dr. Sci. (Med.), Head, Department of standardization of treatment methods

Russian Federation, Moscow

Irina N. Subortseva

National Research Center for Hematology

Email: soubortseva@yandex.ru
ORCID iD: 0000-0001-9045-8653

Cand. Sci. (Med.), senior research associate, Department of diagnosis and treatment of hematological diseases

Russian Federation, Moscow

Аlla A. Shabalina

Research Center of Neurology

Email: ashabalina@yandex.ru
ORCID iD: 0000-0001-9604-7775

Dr. Sci. (Med.), senior research associate, Head, Laboratory diagnostics department

Russian Federation, Moscow

Sofia N. Morozova

Research Center of Neurology

Email: morozova@neurology.ru
ORCID iD: 0000-0002-9093-344X

Cand. Sci. (Med.), researcher associate, Neuroradiology

Russian Federation, Moscow

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2. Fig. 1. Patient selection.

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3. Fig. 2. Clinical patterns in post-stroke patients with MPN (alluvial plots).

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4. Fig. 3. Brain MRI of patients with PV in axial T2 (A—D) and DWI sequences with a b-value of 1,000 s/mm2 (E).

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5. Fig. 4. Brain MRI of patients with ET; axial plane T2-weighted images.

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6. Fig. 5. Brain MRI of patients with PMF in axial T2 images (А, С) and in sagittal T2 FLAIR images (B, D).

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Copyright (c) 2024 Tanashyan М.М., Kuznetsova P.I., Raskurazhev A.A., Melikyan A.L., Subortseva I.N., Shabalina А.A., Morozova S.N.

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This work is licensed under a Creative Commons Attribution 4.0 International License.

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