Simultaneous onset of haemorrhagic and ischaemic strokes in a haemodialysis patient.
Primary brain haemorrhage and infarction only very rarely occur simultaneously. A patient with end stage renal disease from diabetic nephropathy suddenly had motor aphasia and horizontal nystagmus soon after finishing haemodialysis. Neuroradiological studies showed a haematoma on the right side of the pons and an infarct in the left frontal lobe with occlusion of the left internal carotid artery. Specific conditions of the haemodialysis--including anticoagulant use, relative hypovolaemia and hypertension just before haemodialysis, and an abrupt decrease in blood pressure during haemodialysis--seemed to be the major reason for the simultaneous onset of dual strokes.
Toyoda
K
K
Stroke Centre, Fukuoka Red Cross Hospital, Fukuoka, Japan. k-toyoda@mb6.seikyou.ne.jp
Kumai
Y
Y
Fujii
K
K
Ando
T
T
Ibayashi
S
S
D000368:Aged; D002545:Brain Ischemia / Q000209:etiology* / Q000473:pathology; D002343:Carotid Artery, Internal / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000209:etiology* / Q000473:pathology; D015897:Comorbidity; D005260:Female; D006406:Hematoma / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D006435:Renal Dialysis / Q000009:adverse effects*; D020521:Stroke / Q000209:etiology* / Q000473:pathology