Ischaemic stroke with ovarian hyperstimulation syndrome.
Ovarian hyperstimulation syndrome (OHSS) is a rare and serious complication of hormonal treatment for induction of ovulation. Haemoconcentration owing to the large fluid shift from the intravascular to the peritoneal cavity resulting in increased blood viscosity that can lead to arterial and venous occlusion. Thromboembolic stroke, cerebral venous thrombosis and systemic arteriovenous thrombosis have been reported in OHSS. We report a case of a 30-year-old female who had undergone a successful in vitro fertilization and presented in the emergency department with sudden onset of left hemiplegia. Her CT scan showed a full thickness right- MCA territory infarct. The patient was treated with oral aspirin, intra venous plasma expanders and Mannitol. Her repeat MRI showed haemorrhagic conversion of infarct. She made a good recovery and was independent in activities of daily living when seen for follow up after six months.
Qazi
Amna
A
Department of Medicine, Shifa International Hospital and College of Medicine, H-8/4, Islamabad, Pakistan.
Ahmed
Aamir Nazir
AN
Qazi
Mah Parveen
MP
Usman
Faika
F
Ahmad
Arsalan
A
D000328:Adult; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects*; D006429:Hemiplegia / Q000209:etiology; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000150:complications / Q000175:diagnosis / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D016471:Ovarian Hyperstimulation Syndrome / Q000150:complications* / Q000209:etiology / Q000628:therapy; D010154:Pakistan; D011247:Pregnancy