2023 Volume 45 Issue 3 Pages 264-269
The patient was a 68-year-old male. He was taken to a hospital by ambulance with a chief complaint of difficulty moving. During his visit, he was found to be suffering from monoparesis of the left leg, with a cerebral infarction observed in the right anterior cerebral artery region on both CT and MRI. In addition, since he had fecal incontinence associated with a large amount of black stool and with a blood test indicating anemia of Hb 6.2 g/dl, gastrointestinal bleeding was suspected. Gastric ulcers were confirmed after performing upper gastrointestinal endoscopy. A thrombus was observed in the left internal carotid artery via a carotid duplex ultrasound, which was performed for the purpose of investigating the cause of the cerebral infarction, with a CTA indicating a large number of thrombi not only in the carotid artery but also in the abdominal aorta and pulmonary artery. Since we determined that the carotid thrombosis had a high risk of progressing to a cerebral infarction, daily ultrasound scans were performed as a follow-up. However, a new cerebral infarction occurred due to carotid thrombus dispersion. A cerebral infarction due to thrombosis throughout the entire body in association with anemia has only been rarely reported. We herein report the pathophysiology of this rate case with a review of the pertinent literature.
