title: Cerebral infarcts associated with adenomyosis among middle-aged women.
abstract: Cerebral infarcts associated with hypercoagulability in malignant tumors have been well recognized. However, reports on cerebral infarcts in patients with a benign gynecologic tumor, such as adenomyosis, are extremely limited. We report the cases of 4 patients with adenomyosis and cerebral infarcts, all without obvious evidence of conventional causes of cerebral infarcts. Brain magnetic resonance imaging revealed multiple cerebral infarcts in both cortical and subcortical areas in all the patients and in different arterial territories in 3 patients. Two patients also had systemic embolism in the fingers or kidneys. One patient had thrombi in the brachiocephalic trunk and left subclavian artery. The levels of coagulation markers were elevated in the acute phase of cerebral infarcts. Although cerebral infarcts might be uncommon in adenomyosis patients, these patients might be potentially at risk of developing cerebral infarcts associated with hypercoagulability related to increased mucinous tumor marker levels, menstruation-related coagulopathy, or increased tissue factor expression levels. Additional study is required to determine the mechanism underlying the development of cerebral infarcts in adenomyosis; however, physicians need to pay particular attention to those who have hypercoagulability with adenomyosis among middle-aged women.
authors.affiliation: Department of Neurology, Juntendo University Shizuoka Hospital, Izunokunishi, Shizuoka, Japan. kazuo-y@juntendo.ac.jp
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yamashiro
authors.forename: Ryota
authors.initials: R
authors.lastname: Tanaka
authors.forename: Kenya
authors.initials: K
authors.lastname: Nishioka
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ueno
authors.forename: Hideki
authors.initials: H
authors.lastname: Shimura
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Okuma
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Hattori
authors.forename: Takao
authors.initials: T
authors.lastname: Urabe
mesh_terms: D062788:Adenomyosis / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation; D002544:Cerebral Infarction / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D038524:Diffusion Magnetic Resonance Imaging; D004617:Embolism / Q000209:etiology; D005260:Female; D005385:Fingers / Q000098:blood supply; D006801:Humans; D007668:Kidney / Q000098:blood supply; D018810:Magnetic Resonance Angiography; D008875:Middle Aged; D019851:Thrombophilia / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D015415:Biomarkers