Unmasking cerebral infarction: hemianopia and heavy menstrual bleeding in a patient with adenomyosis and vascular abnormalities

Unmasking cerebral infarction: hemianopia and heavy menstrual bleeding in a patient with adenomyosis and vascular abnormalities

Adenomyosis, Cerebral infarction, Heavy menstrual bleeding, Carotid artery stenosis

Abstract
Background Adenomyosis, typically associated with heavy menstrual bleeding and pelvic pain, is rarely linked to
neurological complications. This case presents a rare instance of ischemic stroke in a young patient with adenomyosis
and vascular abnormalities, underscoring the role of anemia, hypercoagulability, and vascular factors as potential
contributors to cerebral infarction.

Case presentation We describe a 41-year-old female with a history of adenomyosis who presented with right-
sided hemianopia and dizziness following severe menstrual bleeding. Imaging revealed multiple acute cerebral

infarctions and diffuse narrowing of the left internal carotid artery, suggesting an underlying vascular pathology.
Thrombelastography revealed a hypercoagulable state, raising questions about the contributions of systemic and
vascular factors in the context of adenomyosis.
Conclusion This case highlights the need for a multidisciplinary approach in young patients with atypical risk factors.
The findings underscore the importance of considering gynecological, vascular, and coagulation abnormalities in the
evaluation of cerebrovascular events, offering new insights into diagnostic and therapeutic strategies.
Keywords Adenomyosis, Cerebral infarction, Heavy menstrual bleeding, Carotid artery stenosis

Qing Wan1†, Chao Wang2†, Weiyue Zhang1

, Weijia Zhong2

, Haoran Wang2

, Hee King SU2

, Mei Hwa Joanne HNG2
,

Fan Yang3
and Xiaoguang Li1*

https://doi.org/10.1186/s12245-024-00779-y

2025

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