Cerebral borderzone infarcts after phlebotomy.
We describe a 68-year-old patient with cerebral ischaemia who underwent a phlebotomy to lower an elevated haematocrit (0.61 l/l. The procedure was complicated by the development of a total hemiplegia after two hours. CT scanning showed two borderzone infarcts. We conclude that the plasma volume of patients with cerebral ischaemia and a high haematocrit may be contracted to such an extent that venesection is hazardous. The most appropriate treatment in these patients is expansion of the plasma volume.
D000368:Aged; D001815:Bloodletting / Q000009:adverse effects*; D001921:Brain / Q000000981:diagnostic imaging; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000628:therapy*; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed