Syed Mazhar Ali Naqvi, Sumaira Aziz, Hafeeza Naz, Muhammad Javed, Saba Zartash.
Hyperhomocysteinemia Leading to Ischemic Stroke in A 32 Year Old Male.
Esculapio J Services Inst Med Sci Jan ;8(1):42-5.

Homocysteinemia is an independent risk factor for stroke. It may be inherited or acquired. Low B12 and folate levels are associated with hyperhomocysteinemia. We report a case of a 32 years old male who developed left MCA ischemic stroke with right hemiplegia on 4th admission day after attempted suicide with benzodiazepines. His MCV was raised and macro-ovalocytes were present on periheral film. His serum B12 and red cell folate levels were markedly reduced and homocysteine levels were markedly reaised. This led to hypercoagulable state in this patient which resulted in left internal artery occlusion by a large thrombus leading to stroke. Other factors for hypercoagulability were found negative. Patient's clinical status and MCV improved on replacement therapy with B12, B6 and folic acid.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com