Case Presentation A 20-year-old female presented to the hos
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Akhilesh Agarwal
Case Presentation

A 20-year-old female presented to the hospital after being involved in a motor vehicle accident. The accident was preceded by a sensation of dizziness with blurring of vision and brief loss of consciousness. Her co-passengers, who witnessed the event, denied noticing any seizure-like activity. She regained consciousness within a few minutes, at which time she was alert and responding appropriately. Upon arrival to the hospital, she was noted to have some chest pain where the air bag had deployed but did not have any signs of significant trauma. She endorsed continued dizziness, blurring of vision, and photophobia. Also, she attested to some weakness in her left side involving her arms and legs. On physical exam, she demonstrated decreased motor strength in her left upper extremity but otherwise intact neurological exam.

An initial head CT was negative for any ischemic changes. Laboratory tests revealed severe anemia with hemoglobin of 5.8 mg/dL and platelet count of 564, suggestive of reactive thrombocytosis. Patient also was found to have serum iron 20????dL, TIBC 481????dL, iron saturation 6%, and serum ferritin 39ng/mL. MCV was 64 fL/cell and RDW was 18.2%.

History revealed menorrhagia with multiple evaluations for near syncope and dizziness. However, she did not have active bleeding at the time of presentation. She demonstrated significant neurological findings on physical exam with worsening left upper extremity strength, bilateral dysmetria, and a positive Romberg sign. MRI at the time revealed bilateral cerebellar and left occipital lobe nonhemorrhagic infarcts.


Question: What is the possible cause of the given condition? What is the treatment plan?

For the full case report, refer to: https://www.hindawi.com/journals/crim/2017/1684631/
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