Hemostasis disorders and cryptogenic ischemic stroke in young women: clinical cases

Abstract

Summary. Introduction. The spectrum of ischemic stroke (IS) subtypes continues to include rare or undiagnosed cryptogenic forms. Identifying their etiology remains challenging and necessitates a meticulous approach, primarily to guide tailored secondary prevention strategies that account for individual risk factors. Aim: to identify factors associated with the development of the hemorheological IS subtype in young patients. Materials and Methods. This article describes two clinical cases of acute cerebrovascular accidents classified as hemorheological IS (according to the pathogenetic classification by Russian Center of Neurology and Neurosciences). Clinical features of the disease, neuroimaging data (including multimodal magnetic resonance imaging), and targeted genetic testing are presented, enabling timely etiological diagnosis of IS in young adults. Results. The study highlights potentially hemodynamically significant mutations identified in these cases. These mutations together with risk factors such as combined oral contraceptive (COC) use, smoking, and alcohol consumption may underlie the pathogenesis of acute cerebrovascular accident. Conclusion. Hemorheological microocclusion represents cryptogenic IS subtype observed in young women using COC. Consequently, comprehensive screening of hemorheological parameters and thrombophilic mutations is critical in this patient population.

For citation: Annushkin V.A., Lagoda O.V., Shabalina A.A. Hemostasis disorders and cryptogenic ischemic stroke in young women: clinical cases. Tromboz, gemostaz i reologiya. 2026;(1):101–107. (In Russ.).

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