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A Case of Hypertension with Systemic Multiple Arterial Stenosis Accompanied by Acute Cerebellar Infarction

Received: 19 August 2020     Accepted: 27 August 2020     Published: 14 September 2020
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Abstract

Hypertension is a recognized risk factor for stroke and recurrent stroke. Studies have found that more than 75% of patients with acute stroke are associated with elevated blood pressure. We report a patient of hypertension with ischemic stroke who had a history of lymphoma and developed systemic atherosclerosis with good control of long-term blood glucose and lipid. Based on the literature, the etiology and treatment were discussed, suggesting that the cause of atherosclerosis may be related to the radiotherapy, chemotherapy and targeted therapy of lymphoma. It is pointed out that the target of blood pressure should be determined according to the actual situation of the patient rather than guadlines only. At the same time, the difference between stroke and coronary arterial disease in the secondary prevention was also revealed. Ticagrelor does not reduce the risk in the secondary prevention of ischemic stroke, and 21-day dual antiplatelet therapy (aspirin and clopidogrel) is recommended for patients with mild stroke starting within 24 hours to prevent stroke recurrence within 90 days.

Published in Science Journal of Clinical Medicine (Volume 9, Issue 3)
DOI 10.11648/j.sjcm.20200903.13
Page(s) 54-57
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Hypertension, Ischemic Stroke, Atherosclerosis, Arterial Stenosis, The Secondary Prevention of Ischemic Stroke

References
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[2] Cipolla MJ, Liebeskind DS, Chan SL. The importance of comorbidities in ischemic stroke: Impact of hypertension on the cerebral circulation [J]. Journal of cerebral blood flow and metabolism: official journal of the International Society of Cerebral Blood Flow and Metabolism 2018, 38 (12): 2129-2149.
[3] Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association [J]. Stroke 2019, 50 (12): e344-e418.
[4] Hankey GJ. Secondary stroke prevention [J]. The Lancet Neurology 2014, 13 (2): 178-194.
[5] Libby P, Buring JE, Badimon L, et al. Atherosclerosis [J]. Nature reviews Disease primers 2019, 5 (1): 56.
[6] Min SS, Wierzbicki AS. Radiotherapy, chemotherapy and atherosclerosis [J]. Current opinion in cardiology 2017, 32 (4): 441-447.
[7] Seijkens TTP, Lutgens E. Cardiovascular oncology: exploring the effects of targeted cancer therapies on atherosclerosis [J]. Current opinion in lipidology 2018, 29 (5): 381-388.
[8] Perry HM, Bender TP, McNamara CA. B cell subsets in atherosclerosis [J]. Frontiers in immunology 2012, 3: 373.
[9] Srikakulapu P, McNamara CA. B cells and atherosclerosis [J]. American journal of physiology Heart and circulatory physiology 2017, 312 (5): H1060-h1067.
[10] Upadhye A, Sturek JM, McNamara CA. 2019 Russell Ross Memorial Lecture in Vascular Biology: B Lymphocyte-Mediated Protective Immunity in Atherosclerosis [J]. Arteriosclerosis, thrombosis, and vascular biology 2020, 40 (2): 309-322.
[11] Popi AF. B-1 phagocytes: the myeloid face of B-1 cells [J]. Annals of the New York Academy of Sciences 2015, 1362: 86-97.
[12] Alhakeem SS, Sindhava VJ, McKenna MK, et al. Role of B cell receptor signaling in IL-10 production by normal and malignant B-1 cells [J]. Annals of the New York Academy of Sciences 2015, 1362 (1): 239-249.
[13] Qureshi AI. Acute hypertensive response in patients with stroke: pathophysiology and management [J]. Circulation 2008, 118 (2): 176-187.
[14] Johnston KC, Mayer SA. Blood pressure reduction in ischemic stroke: a two-edged sword? [J]. Neurology 2003, 61 (8): 1030-1031.
[15] Wallentin L, Becker RC, Budaj A, et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes [J]. The New England journal of medicine 2009, 361 (11): 1045-1057.
[16] Gurbel PA, Bliden KP, Butler K, et al. Randomized double-blind assessment of the ONSET and OFFSET of the antiplatelet effects of ticagrelor versus clopidogrel in patients with stable coronary artery disease: the ONSET/OFFSET study [J]. Circulation 2009, 120 (25): 2577-2585.
[17] Johnston SC, Amarenco P, Albers GW, et al. Ticagrelor versus Aspirin in Acute Stroke or Transient Ischemic Attack [J]. The New England journal of medicine 2016, 375 (1): 35-43.
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Cite This Article
  • APA Style

    Yun Pan, Hailing Liao, Dongdong Chen, Jiaxiong Tan. (2020). A Case of Hypertension with Systemic Multiple Arterial Stenosis Accompanied by Acute Cerebellar Infarction. Science Journal of Clinical Medicine, 9(3), 54-57. https://doi.org/10.11648/j.sjcm.20200903.13

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    ACS Style

    Yun Pan; Hailing Liao; Dongdong Chen; Jiaxiong Tan. A Case of Hypertension with Systemic Multiple Arterial Stenosis Accompanied by Acute Cerebellar Infarction. Sci. J. Clin. Med. 2020, 9(3), 54-57. doi: 10.11648/j.sjcm.20200903.13

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    AMA Style

    Yun Pan, Hailing Liao, Dongdong Chen, Jiaxiong Tan. A Case of Hypertension with Systemic Multiple Arterial Stenosis Accompanied by Acute Cerebellar Infarction. Sci J Clin Med. 2020;9(3):54-57. doi: 10.11648/j.sjcm.20200903.13

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  • @article{10.11648/j.sjcm.20200903.13,
      author = {Yun Pan and Hailing Liao and Dongdong Chen and Jiaxiong Tan},
      title = {A Case of Hypertension with Systemic Multiple Arterial Stenosis Accompanied by Acute Cerebellar Infarction},
      journal = {Science Journal of Clinical Medicine},
      volume = {9},
      number = {3},
      pages = {54-57},
      doi = {10.11648/j.sjcm.20200903.13},
      url = {https://doi.org/10.11648/j.sjcm.20200903.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.20200903.13},
      abstract = {Hypertension is a recognized risk factor for stroke and recurrent stroke. Studies have found that more than 75% of patients with acute stroke are associated with elevated blood pressure. We report a patient of hypertension with ischemic stroke who had a history of lymphoma and developed systemic atherosclerosis with good control of long-term blood glucose and lipid. Based on the literature, the etiology and treatment were discussed, suggesting that the cause of atherosclerosis may be related to the radiotherapy, chemotherapy and targeted therapy of lymphoma. It is pointed out that the target of blood pressure should be determined according to the actual situation of the patient rather than guadlines only. At the same time, the difference between stroke and coronary arterial disease in the secondary prevention was also revealed. Ticagrelor does not reduce the risk in the secondary prevention of ischemic stroke, and 21-day dual antiplatelet therapy (aspirin and clopidogrel) is recommended for patients with mild stroke starting within 24 hours to prevent stroke recurrence within 90 days.},
     year = {2020}
    }
    

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    AB  - Hypertension is a recognized risk factor for stroke and recurrent stroke. Studies have found that more than 75% of patients with acute stroke are associated with elevated blood pressure. We report a patient of hypertension with ischemic stroke who had a history of lymphoma and developed systemic atherosclerosis with good control of long-term blood glucose and lipid. Based on the literature, the etiology and treatment were discussed, suggesting that the cause of atherosclerosis may be related to the radiotherapy, chemotherapy and targeted therapy of lymphoma. It is pointed out that the target of blood pressure should be determined according to the actual situation of the patient rather than guadlines only. At the same time, the difference between stroke and coronary arterial disease in the secondary prevention was also revealed. Ticagrelor does not reduce the risk in the secondary prevention of ischemic stroke, and 21-day dual antiplatelet therapy (aspirin and clopidogrel) is recommended for patients with mild stroke starting within 24 hours to prevent stroke recurrence within 90 days.
    VL  - 9
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Author Information
  • Department of Cardiology, the First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Cardiology, the First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Cardiology, the First Affiliated Hospital of Jinan University, Guangzhou, China

  • Department of Hematology, the First Affiliated Hospital of Jinan University, Guangzhou, China

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