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We report the presenting neurologic and visual symptoms in 17 patients with primary thrombocythemia.Poorly localizing symptoms occurred in 14 patients:transient unsteadiness in 13,dysarthria in eight,and scintillating scotoma in four.Nine patients had focal symptoms:transient monocular blindness in two patients,transient mono-or hemiparesis in six, and both of these in one patient.The attacks all had a sudden onset, occurred sequentially rather than simultaneously,lasted for a few seconds to several minutes,and were usually associated with a dull or pulsatile headache.A causal platelet-mediated arterial thrombosis was evident in 15 patients.There were no recurrences of thrombotic or ischemic events during long-term treatment of 12 patients with aspirin and during cytostatic reduction of platelet count to normal in seven patients.We conclude that low-dose aspirin and reduction of platelet count to normal are effective, but coumarin is ineffective,in the treatment and prevention of arterial thrombosis in thrombocythemia. |
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