Transcranial Doppler Detection of Microemboli in a Stroke Patient with Polycythemia rubra vera

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Abstract
We report a case of a 63-year-old man without known risk factors for cerebrovascular disease who developed a right hemiparesis with slow onset and subsequent clinical improvement. Cerebral computed tomography and magnetic resonance showed two left hemispheric infarctions with hemorrhagic transformation. Transcranial Doppler examination showed a left middle cerebral artery stenosis and frequent high-intensity transient signals (HITS) only on the left side. Hematological tests revealed polycythemia rubra vera. Clinical improvement was associated with a reduction in the number of HITS on transcranial Doppler and a reduction in hematocrit levels. To our knowledge, this is the first report of HITS on transcranial Doppler in a stroke patient with polycythemia rubra vera

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