Cerebral thrombosis in a postmenopausal woman on HRT.
We report stroke in a 62-year-old woman who had been on hormone replacement therapy (HRT), estrogen plus progestin, for more than 8 years. She experienced two episodes of transient ischemic attack (TIA), manifesting as right-sided weakness, that persisted for 10-20 min. Magnetic resonance angiography (MRA) obtained before complete stroke, demonstrated severe stenosis of the left middle cerebral artery, without evidence of cerebral infarction. Twenty days after the TIA she suffered a complete stroke corresponding with the site of stenosis. Her protein S activity was low 29%. In the context of the recent findings of the US Women's Health Initiative, we concur that the safety of long-term HRT should be considered carefully, especially in women with a history of TIA and confirmed cerebral artery stenosis.
Inoue
Nobuhiro
N
Department of Neurosurgery, Health and Insurance Hitoyoshi General Hospital, Japan. nh-inoue-15@giga.ocn.ne.jp
Ichimura
Homare
H
Goto
Satoshi
S
Ushio
Yukitaka
Y
D001921:Brain / Q000473:pathology; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D020767:Intracranial Thrombosis / Q000209:etiology* / Q000473:pathology; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D020521:Stroke / Q000209:etiology / Q000473:pathology