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These six patients represented 0.54%of all patients with first stroke,42. 8%of all hematologic disorders associated with stroke,and 12.5%of all patients with essential thrombocythemia diagnosed from 1986 to 1992 at our institution.Eleven acute cerebrovascular accidents(6 transient ischemic attacks,5 definitive cerebral infarcts)were registered.Mean time from ischemic stroke to diagnosis of essential thrombocythemia was 4.5 months (range,1 to 12-months).The mean platelet count was 597x10(9)/L(range,414 to 760x10(9)/L).Four patients had platelets counts lower than 600x10(9)/L. All patients had circulating erythroid progenitors,megakaryocytic progenitors,or both.Ischemic stroke as a presenting manifestation of essential thrombocythemia is probably underrecognized.The diagnosis of thrombocythemia should not be excluded on the basis of platelet counts lower than 600x10(9)/L.The availability of in vitro culture of hematopoietic progenitors from peripheral blood makes it possible to diagnose early and atypical cases. |
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