title: Etiology and treatment of ischaemic stroke in patients with β-thalassemia major.
abstract: OBJECTIVE
  Although hypercoagulability-induced thromboembolism is generally accepted as cause of cerebral ischaemia in thalassemic patients, cardiogenic embolism has been recently suggested as another possible stroke etiology.
  
  
  METHODS
  We present four adult β-thalassemia major patients with manifest cardiac involvement who suffered territorial strokes.
  
  
  RESULTS
  In the presence of siderotoxic cardiomyopathy and arrhythmia, we assumed cardiogenic embolism as etiology of stroke and initiated oral anticoagulation as preventive medication. Two of our patients were the first β-thalassemia major patients who underwent successful thrombolysis with rtPA.
  
  
  CONCLUSIONS
  Cardioembolism seems to be the cause of stroke in cases of β-thalassemia major. Thrombolysis can be applied in the setting of acute brain ischaemia in such high risk patients.
authors.affiliation: First Department of Neurology, University of Athens Medical School, Eginition Hospital, Greece.
authors.forename: S
authors.initials: S
authors.lastname: Vassilopoulou
authors.forename: E
authors.initials: E
authors.lastname: Anagnostou
authors.forename: G
authors.initials: G
authors.lastname: Paraskevas
authors.forename: K
authors.initials: K
authors.lastname: Spengos
mesh_terms: D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use*; D001037:Aphasia / Q000209:etiology; D001281:Atrial Fibrillation / Q000209:etiology; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D009202:Cardiomyopathies / Q000209:etiology; D002311:Cardiomyopathy, Dilated / Q000150:complications; D015913:Chelation Therapy; D003131:Combined Modality Therapy; D005260:Female; D006429:Hemiplegia / Q000209:etiology; D006486:Hemosiderosis / Q000209:etiology; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000188:drug therapy / Q000209:etiology; D020766:Intracranial Embolism / Q000150:complications; D008297:Male; D013156:Splenectomy; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D065227:Transfusion Reaction; D017086:beta-Thalassemia / Q000150:complications* / Q000188:drug therapy / Q000601:surgery / Q000628:therapy
chemical_list: D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants; D010959:Tissue Plasminogen Activator