A Stroke of Undetermined Source in Geriatrics
Journal Title: International Journal of Medical and Pharmaceutical Case Reports - Year 2015, Vol 3, Issue 2
Abstract
Presentation of the Case: Criptogenetic strokes represent a challenge, particularly in geriatrics as the patient’s clinical complexity, the polipharmacotherapy, the epigenetic modifications of a life course may complicate the case clinical presentation and the prognosis. We report the case of a young old woman admitted to hospital for an ischemic stroke recurrence associated to a leg deep venous thrombosis. The medical history was negative for traditional cardiovascular risk factors, excluding a mild carotid atherosclerotic plaque, for rheumatologic/autoimmune or oncological diseases. Haematological malignancies were also ruled out. The coagulative panel showed the prothrombin G202110A gene heterozygote mutation. Discussion: The clinical case adds an interesting narrative frame to the issue of criptogenetic strokes in geriatrics; the mutation of the prothrombin G202110A gene might act synergistically to comorbidity disrupting the atherosclerotic plaque. Immunosenescence, clinical frailty, gender difference and the epigenetic modifications might contribute to stratify a higher pro thrombotic risk for this individual patient. Conclusion: This case strengthens the need to tackle the elderly clinical complexity, through tailored approaches on the single patient.
Authors and Affiliations
Fiammetta Monacelli, Federica Gandolfo, Patrizio Odetti
Keywords
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- EP ID EP343876
- DOI 10.9734/IJMPCR/2015/14411
- Views 69
- Downloads 0
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