title: Young Ischemic Stroke in Association with Ovarian Hyperstimulation Syndrome.
abstract: BACKGROUND
  Ovarian hyperstimulation syndrome (OHSS) is a serious and potentially fatal complication of medical ovarian stimulation. Uncommonly, it is associated with thromboembolic complications with venous thrombosis being more common than arterial thromboembolic events. We present a case of cerebral infarction in the setting of severe OHSS secondary to in vitro fertilization treatment with no residual neurological deficits.
  
  
  METHODS
  We also performed a review of previously published ischemic cerebral infarction and cerebral venous sinus thrombosis (CVST) cases associated with OHSS to evaluate common patterns in presentations, commonly affected central nervous system sites, trends for therapeutic options in these cases, and outcomes.
  
  
  CONCLUSIONS
  We have included 27 cases of ischemic cerebral infarction and 7 cases of CVST previously published in English literature. We have included cases of central retinal artery occlusion in the ischemic cerebral infarction group, and central retinal vein occlusion in the CVST group. Mean ages of presentation were 31 ± 4.84 and 34 ± 4.90 years for ischemic cerebral infarction and CVST, respectively. Ischemic strokes commonly affect large cortical areas with unilateral weakness, aphasia, unilateral sensory changes, and visual field deficits being the common presentations. Middle cerebral artery (n = 7) is the common site of vascular occlusion where vascular imaging has been reported, followed by internal carotid artery occlusion (n = 5). OHSS cannot be considered a direct risk for pathogenesis, but OHSS is frequently associated with hyperviscosity, which may add to the risk factors.
authors.affiliation: Department of Neurology, Detroit Medical Center/Wayne State University, Detroit, MI. Electronic address: pawani_sachar@yahoo.com.
authors.forename: Pawani
authors.initials: P
authors.lastname: Sachar
authors.affiliation: Department of Neurology, Detroit Medical Center/Wayne State University, Detroit, MI.
authors.forename: Kumar
authors.initials: K
authors.lastname: Rajamani
mesh_terms: D000328:Adult; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D016471:Ovarian Hyperstimulation Syndrome / Q000150:complications* / Q000000981:diagnostic imaging; D020521:Stroke / Q000150:complications* / Q000000981:diagnostic imaging
keywords: Ovarian hyperstimulation syndrome; cerebral venous sinus thrombosis; in vitro fertilization; ischemic stroke