Adenomyosis Accompanied by Multiple Hemorrhagic Cerebral Infarction: A Case Report

Bin Chi, Chi Bin, Meiyan Liu, Pengwei Hou, Jianwu Wu, Shousen Wang
Cureus · 2024 · vol. 16(4) , pp. e59280 · doi:10.7759/cureus.59280 · PMID:38813273 · PMC11136548 · W4396230523
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

This case report details a 46-year-old woman with adenomyosis who developed multiple hemorrhagic cerebral infarctions, which resolved with treatment of the adenomyosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This paper presents a 46-year-old woman with a four-year history of uterine adenomyosis who developed multiple hemorrhagic cerebral infarctions, with imaging showing hemorrhagic foci in several brain regions and subarachnoid hemorrhage; the course was accompanied by elevated D-dimer and CA-125 and episodes of severe anemia. Using CT/MRI and laboratory monitoring, the authors report that after conservative intracranial management plus internal medicine treatment targeting adenomyosis with GnRH-α (leuprorelin), cerebral hemorrhage gradually resolved and D-dimer and hemoglobin normalized, although a right transverse sinus thrombosis was later noted on CT venogram. The authors acknowledge that the evidence is limited to a single case and that the proposed mechanisms linking adenomyosis to hemorrhagic infarctions rely on prior literature rather than direct testing in this patient. This paper is centrally about endometriosis and/or adenomyosis—adenomyosis—specifically uterine adenomyosis complicated by multiple hemorrhagic cerebral infarctions, which is the core subject of the case report.

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Abstract

This study aims to present a case of uterine adenomyosis accompanied by multiple hemorrhagic cerebral infarctions (CIs), summarize therapeutic experiences based on the literature review, and improve the clinical diagnosis and treatment of multiple hemorrhagic CIs. This paper describes a 46-year-old female with a four-year history of uterine adenomyosis complicated by multiple hemorrhagic CIs. During treatment, elevated levels of D-dimer, CA-125, and severe anemia were observed. Following internal medicine treatment targeting uterine adenomyosis and hemorrhagic CIs, the cerebral hemorrhage gradually resolved. Women presenting with multiple CIs, particularly hemorrhagic ones, should be evaluated for the presence of gynecological diseases. Treating gynecological conditions may aid in the management of multiple CIs.

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adenomyosis

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