Case Report: Ischemic Strokes in a Young Woman With Manifestations of Multiple Sclerosis

Background: The current case report aimed at describing the clinical, radiological, and immunologicalfindings of a case of ischemic stroke due to acute thrombosis of the left internal carotid artery andmultiple watershed infarctions mimicking Multiple Sclerosis (MS).Clinical Presentation and Intervention: A 24-year-old right-handed Iranian female was initiallydiagnosed with Multiple Sclerosis (MS). She presented with weakness in right lower limb. Thecerebral Fluid Attenuation Inversion (FLAIR) Magnetic Resonance Imaging (MRI) showed fewsmall and round lesions in deep white matter, semi-oval centrums, paraventricular region, andsubcortical region on left hemisphere. MS was suspected. The patient’s neurological status worsened,after four days she presented hemi-paresis, dysarthria, and hemi-facial paresis. The cerebral Diffusion-Weighted (DW)-MRI, Apparent Diffusion Coefficient (ADC), Duplex Scan (DS), Complete BloodCount (CBC), coagulation, blood chemistry, blood lipids, and autoimmune and immunodiagnosticpathology were performed. Test for Anti-double stain DNA (dsDNA), IgG anti-cardiolipin antibodies,and lupus anticoagulant were positive. DNA bound lactoferrin, anti-Sm antibodies, Anti-Sjögren’s-Syndrome-related Antigen (Anti-SSA) autoantibodies, IgM anti-cardiolipin antibodies, and Antibeta-2 glycoprotein-1 (IgMIgG) were negative. Ischemic stroke due to acute thrombosis of the leftinternal carotid artery and multiple watershed infarctions were confirmed in the patient. Heparin andthen warfarin therapy was started. At that time she was treated with warfarin, hydroxychloroquine(200 mg/d) and atorvastatin (20 mg/d). The outcome was favorable.Conclusion: The current case presented with clinically susceptible symptoms of MS, but had astroke. Therefore, stroke in young patients can mimic MS symptoms

کلیدواژه ها:

Diagnosis ، Multiple Sclerosis ، Stroke