title: Transient neurologic and ocular manifestations in primary thrombocythemia.
abstract: We report the presenting neurologic and visual symptoms in 17 patients with primary thrombocythemia. Poorly localizing symptoms occurred in 14 patients: transient unsteadiness in 13, dysarthria in eight, and scintillating scotomata in four. Nine patients had focal symptoms: transient monocular blindness in two patients, transient mono- or hemiparesis in six, and both of these in one patient. The attacks all had a sudden onset, occurred sequentially rather than simultaneously, lasted for a few seconds to several minutes, and were usually associated with a dull or pulsatile headache. A causal platelet-mediated arterial thrombosis was evident in 15 patients. There were no recurrences of thrombotic or ischemic events during long-term treatment of 12 patients with aspirin and during cytostatic reduction of platelet count to normal in seven patients. We conclude that low-dose aspirin and reduction of platelet count to normal are effective, but coumarin is ineffective, in the treatment and prevention of arterial thrombosis in thrombocythemia.
authors.affiliation: Department of Hematology, University Hospital Dijkzigt, Erasmus University, Rotterdam, The Netherlands.
authors.forename: J J
authors.initials: JJ
authors.lastname: Michiels
authors.forename: P J
authors.initials: PJ
authors.lastname: Koudstaal
authors.forename: A H
authors.initials: AH
authors.lastname: Mulder
authors.forename: H H
authors.initials: HH
authors.lastname: van Vliet
mesh_terms: D000328:Adult; D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D005128:Eye Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology*; D010976:Platelet Count; D011446:Prospective Studies; D012074:Remission Induction; D012307:Risk Factors; D013920:Thrombocythemia, Essential / Q000097:blood / Q000150:complications* / Q000188:drug therapy
chemical_list: D001241:Aspirin