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Stroke Presenting as a Complication of Sarcoidosis in an Otherwise Asymptomatic Patient

A stroke occurring in young patients in the absence of common risk factors needs a thorough investigation of the underlying cause to prevent its recurrence. Herein, we discuss a case of stroke with rare etiology in a 28-year-old male presenting within 30 minutes of speech difficulty and right-sided...

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Autores principales: Memon, Muhamad, AlHazza, Muhammed, Heena, Humariya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5969794/
https://www.ncbi.nlm.nih.gov/pubmed/29805931
http://dx.doi.org/10.7759/cureus.2362
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author Memon, Muhamad
AlHazza, Muhammed
Heena, Humariya
author_facet Memon, Muhamad
AlHazza, Muhammed
Heena, Humariya
author_sort Memon, Muhamad
collection PubMed
description A stroke occurring in young patients in the absence of common risk factors needs a thorough investigation of the underlying cause to prevent its recurrence. Herein, we discuss a case of stroke with rare etiology in a 28-year-old male presenting within 30 minutes of speech difficulty and right-sided weakness. The initial triage workup showed an abnormal configuration of the P wave in the 12 lead echocardiograph (ECG) and his chest x-ray (CXR) showed mediastinal widening. His echocardiogram and chest computed tomography (CT) confirmed bilateral enlargement with restrictive cardiomyopathy and mediastinal lymphadenopathy, raising a suspicion of sarcoidosis. A cardiac positron emission tomography (PET) scan confirmed the diagnosis by showing a non-caseating granuloma. The patient was put on intravenous (IV) tissue plasminogen activator (TPA) and his National Institute of Health Stroke Scale (NIHSS) came down from 14 on admission to zero within 48 hours. Cardiac involvement in sarcoidosis is not uncommon but it presenting as stroke is extremely rare. For a young, previously healthy patient presenting as a stroke without risk factors, sarcoidosis should be considered as a differential diagnosis.
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spelling pubmed-59697942018-05-27 Stroke Presenting as a Complication of Sarcoidosis in an Otherwise Asymptomatic Patient Memon, Muhamad AlHazza, Muhammed Heena, Humariya Cureus Neurology A stroke occurring in young patients in the absence of common risk factors needs a thorough investigation of the underlying cause to prevent its recurrence. Herein, we discuss a case of stroke with rare etiology in a 28-year-old male presenting within 30 minutes of speech difficulty and right-sided weakness. The initial triage workup showed an abnormal configuration of the P wave in the 12 lead echocardiograph (ECG) and his chest x-ray (CXR) showed mediastinal widening. His echocardiogram and chest computed tomography (CT) confirmed bilateral enlargement with restrictive cardiomyopathy and mediastinal lymphadenopathy, raising a suspicion of sarcoidosis. A cardiac positron emission tomography (PET) scan confirmed the diagnosis by showing a non-caseating granuloma. The patient was put on intravenous (IV) tissue plasminogen activator (TPA) and his National Institute of Health Stroke Scale (NIHSS) came down from 14 on admission to zero within 48 hours. Cardiac involvement in sarcoidosis is not uncommon but it presenting as stroke is extremely rare. For a young, previously healthy patient presenting as a stroke without risk factors, sarcoidosis should be considered as a differential diagnosis. Cureus 2018-03-26 /pmc/articles/PMC5969794/ /pubmed/29805931 http://dx.doi.org/10.7759/cureus.2362 Text en Copyright © 2018, Memon et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Neurology
Memon, Muhamad
AlHazza, Muhammed
Heena, Humariya
Stroke Presenting as a Complication of Sarcoidosis in an Otherwise Asymptomatic Patient
title Stroke Presenting as a Complication of Sarcoidosis in an Otherwise Asymptomatic Patient
title_full Stroke Presenting as a Complication of Sarcoidosis in an Otherwise Asymptomatic Patient
title_fullStr Stroke Presenting as a Complication of Sarcoidosis in an Otherwise Asymptomatic Patient
title_full_unstemmed Stroke Presenting as a Complication of Sarcoidosis in an Otherwise Asymptomatic Patient
title_short Stroke Presenting as a Complication of Sarcoidosis in an Otherwise Asymptomatic Patient
title_sort stroke presenting as a complication of sarcoidosis in an otherwise asymptomatic patient
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5969794/
https://www.ncbi.nlm.nih.gov/pubmed/29805931
http://dx.doi.org/10.7759/cureus.2362
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