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Cerebral Infarction in a Young Adult Associated with Protein C Deficiency

A Case Report

Department of Internal Medicine and General Medicine, Saga Medical School, Saga, Japan

Masashi Shirahama

Department of Internal Medicine and General Medicine, Saga Medical School, Saga, Japan

Keizo Ohmori

Department of Internal Medicine and General Medicine, Saga Medical School, Saga, Japan

Toshiaki Sunaga

Department of Internal Medicine and General Medicine, Saga Medical School, Saga, Japan

Protein C deficiency is a cause of thromboembolic disease. Venous thrombosis is the most common clinical manifestation. Arterial thrombosis is unusual and involvement of the intracranial arteries is especially rare. Herein the authors describe a case of cerebellar infarction associated with protein C deficiency and review the relevant medical literature. A thirty-year-old man was hospitalized because of dysarthria, right limb ataxia, and a gait disturbance. Cranial computed tomography disclosed an infarction in the right cerebellar hemisphere and brachium pontis. Three months earlier the patient had had a transient ischemic attack with truncal ataxia and gait disturbances. On admission, the protein C antigen was 57% and protein C activity was 45%. Investigation of family members revealed protein C deficiency in an uncle. Literature review of stroke cases associated with protein C deficiency revealed that most had had a previous vascular event and/or a positive family history or had used oral contraceptives chronically. Protein C deficiency should be considered in young stroke patients with a positive family history of vasooc clusive disease, previous ischemic events, or chronic oral contraceptive use.

Angiology, Vol. 46, No. 2, 169-173 (1995)
DOI: 10.1177/000331979504600212


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