Transient neurologic and ocular manifestations in primary thrombocythemia.
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.
Michiels
J J
JJ
Department of Hematology, University Hospital Dijkzigt, Erasmus University, Rotterdam, The Netherlands.
Koudstaal
P J
PJ
Mulder
A H
AH
van Vliet
H H
HH
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
D001241:Aspirin