CAROTID-ARTERY THROMBUS ASSOCIATED WITH SEVERE IRON-DEFICIENCY ANEMIAAND THROMBOCYTOSIS

Background Thrombus within the carotid artery usually occurs in vessel s with severe atherosclerotic disease and may embolize to cause transi ent ischemic attacks and cerebral infarctions. The risk factors for ca rotid artery thrombus formation in the absence of atherosclerosis are not well characterized. A case series is presented that suggests an as sociation of carotid artery thrombus with severe iron-deficiency anemi a and thrombocytosis. Case Descriptions We describe three women with s evere iron-deficiency anemia and thrombocytosis secondary to menorrhag ia who developed carotid artery thrombi. Thrombi were detected radiogr aphically. The patients were treated with anticoagulation and antiplat elet therapy. In two patients, followup neuroimaging 10 to 14 days lat er demonstrated resolution of the thrombus and no identifiable vascula r disease. Conclusions Severe iron-deficiency anemia with thrombocytos is may be a risk factor for carotid artery thrombus formation. Medical management with anticoagulation and antiplatelet therapy is a reasona ble approach for these patients while the thrombus resolves.