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“Two-in-one” stroke – protein C and S deficiencies and meningioma in a young patient

Carolina Miguel Gonçalvesa, Cátia Fariaa, Pedro Neves Tavaresa, Fátima Saraivaa, Maria Jesus Banzaa, João Moraisa,b
a Hospitalar de Leiria
b ciTechCare – Center for Innovative Care and Health Technology. Polytechnic of Leiria

Published: 25 September 2022



Introduction: Ischemic stroke is a leading cause of death and morbidity worldwide. There are multiple etiologies and, in rare cases, protein C and S deficiencies and meningioma may contribute to its occurrence.

Case description: A 39-year-old woman, with past medical history of meningioma, presented with 1-day history of dysarthria, right facial palsy and sensation loss of the right hand (National Institute of Health Stroke Scale (NIHSS) of 3 points). Head computed tomography reported a left middle cerebral artery stroke and she was hospitalized. Etiologic investigations revealed decreased levels of protein C and S and head magnetic resonance imaging revealed a meningioma extending into left cavernous sinus meningioma with internal carotid stenosis. During hospital stay her neurological deficits resolved completely and she was started in high dose statin and long-term therapeutic anticoagulation.

Discussion Whereas thrombophilias are associated with increased venous thromboembolism, its association with arterial events is controversial, despite several cases reported. Similarly, meningiomas are rarely associated with stroke. Etiologic investigations in cases of stroke in young individuals are essential to provide the best care to these patients.

Subject area: Secondary prevention of cardiovascular disease

“Two-in-one” stroke – protein C and S deficiencies and meningioma in a young patient


Carolina Miguel Gonçalves

Centro Hospitalar de Leiria

Cátia Faria

Centro Hospitalar de Leiria

Pedro Neves Tavares

Centro Hospitalar de Leiria

Fátima Saraiva

Centro Hospitalar de Leiria

Maria Jesus Banza

Centro Hospitalar de Leiria

João Morais

Centro Hospitalar de Leiria
ciTechCare – Center for Innovative Care and Health Technology. Polytechnic of Leiria

Correspondence to [email protected]

Subject area: Secondary prevention of cardiovascular disease


“Two-in-one” stroke – protein C and S deficiencies and meningioma in a young patient

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Subject areas

> Imaging

— Multimodality
— Echocardiography
— Cardiac magnetic resonance imaging
— Cardiac computed tomography
— Nuclear techniques

> Coronary artery disease

— Acute coronary syndrome
— Chronic coronary syndrome

> Valvular heart disease

— Aortic regurgitation
— Aortic stenosis
— Mitral regurgitation
— Mitral stenosis
— Tricuspid regurgitation
— Tricuspid stenosis
— Pulmonary regurgitation
— Pulmonary stenosis
— Multivalvular disease
— Prosthetic valves
— Endocarditis

> Rhythm disorders

— Syncope — Atrial fibrillation
— Atrial flutter
— Supraventricular tachycardia
— Ventricular arrhythmia
— Bradycardia
— Cardiac ion channel dysfunction
— Pacemaker
— Implantable cardioverter-defibrillator
— Cardiac resynchronization therapy device

> Heart Failure

— Heart failure with reduced ejection fraction
— Heart failure with mildly reduced ejection fraction
— Heart failure with preserved ejection fraction
— Acute heart failure
— Cardiomyopathy
— Pericardial disease
— Right heart dysfunction
— Cardiac dysfunction in oncology patients

> Acute cardiovascular care

— Post-cardiac arrest
— Critically ill cardiac patient
— Patient after percutaneous cardiac procedure
— Patient after cardiac surgery
— End-of-life care in a critically ill cardiac patient

> Prevention, rehabilitation, sports

— Heart disease in the athlete (Sports Cardiology)
— Arterial hypertension
— Dyslipidaemia
— Heart disease in diabetes
— Primary prevention of cardiovascular disease
— Secondary prevention of cardiovascular disease
— Cardiac rehabilitation

> Miscellaneous

— Cardiac tumour
— Aortic disease
— Trauma to the aorta or the heart
— Peripheral artery disease
— Thromboembolic venous disease
— Pulmonary thromboembolism
— Pulmonary hypertension
— Adult congenital heart disease
— Pregnancy and heart disease
— Digital health in Cardiology


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