A case of cerebral infarction caused by PCV
Polycythemia vera (PV) is a cloned erythrocytotic disease manifested by high proliferation and apoptosis in the bone marrow. The clinical symptoms of PV are occult. In practice, patients with cerebral infarction caused by PV are prone to misdiagnosis and missed diagnosis.

Published in the Medicine, the authors report a case of misdiagnosis of PV leading to cerebral infarction. The patient was a middle-aged woman who was diagnosed with acute cerebral infarction in the outpatient hospital. After treatment, the patient still had left hemiplegia, dizziness and other symptoms.

Sufficient evidence of atherosclerotic processes in the brain infarction was not found. However, the patient's signs and laboratory examination indicated a high suspicion of PV. A series of further examinations confirmed the final diagnosis. Bone marrow suppression medications (oral hydroxyurea and subcutaneous injection of interferon) were given and subsequent prevention of cerebral infarction was implemented.

Clinical Pearls:-
• If a patient presents with red and purple skin color and their RBC volume is increased significantly, one should pay special attention to possible PV.

• In cases of thrombosis, the possibility of PV should be highly suspected, further bone marrow-related examination should be performed, and JAK2 gene testing should be performed if conditions permit.

• Patients with acute cerebral infarction should be considered comprehensively, and rare causes of infarction should not be ignored.

• Early diagnosis and treatment can significantly improve the prognosis of patients.

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