Recurrent Cerebral Infarction Associated with Uterine Adenomyosis

In: Journal of the Korean Neurological Association · 2022 · vol. 40(2) , pp. 185–188 · doi:10.17340/jkna.2022.2.16 · W4225130363
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AI-generated summary by claude@2026-06, 2026-06-08

This paper reports a woman with uterine adenomyosis who experienced recurrent cerebral infarctions, highlighting adenomyosis as an under-recognized cause of stroke due to a hypercoagulable state.

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AI-generated deep summary by claude@2026-06, 2026-06-08

This paper reports a 49-year-old woman with uterine adenomyosis who experienced four episodes of recurrent cerebral infarction over about 7 years, investigated with serial neuroimaging, cardiac/vascular embolic workups (including transesophageal/transthoracic echocardiography and 24-hour Holter monitoring), and repeated coagulation and tumor-marker testing. The key finding is that, during acute infarction periods, she had markedly elevated D-dimer and mucinous tumor markers CA125 and CA19-9 alongside a substantially enlarged adenomyotic uterus, while embolic sources were not identified; major caveats include that the report is based on a single case and does not establish causality or pinpoint the exact mechanism beyond the suggested hypercoagulable link. Treatment included antiplatelet and later anticoagulation (eventually warfarin), with hormonal therapy (leuprolide) and gynecologic management decisions affecting recurrence. This paper is centrally about endometriosis—specifically uterine adenomyosis—because it describes recurrent cerebral infarction episodes attributed to adenomyosis-associated hypercoagulability and related elevations in CA125/CA19-9 and D-dimer.

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Abstract

Uterine adenomyosis, which is known as a benign gynecological disease, can induce hypercoagulable state and be an uncommon cause of cerebral thromboembolism, as cerebral infarction is common in patients with malignant neoplasm. We report a woman with uterine adenomyosis who shows several episodes of cerebral infarction and discuss the stoke mechanism and treatment of this under-recognized etiology of stroke.

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adenomyosis

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