Unexplained brain stroke

[Zcq660]

Hello,

I'm writing on behalf of my sister, who has been experiencing a series of puzzling health problems following a recent brain stroke. Despite multiple visits to doctors, we haven't been able to pinpoint the cause or find effective treatments. I'm hoping to gather insights or suggestions from this community.

Here are some key details about her situation:

- Low ferritin levels (3.5 ng/ml)
- Low transferrin saturation (4.4%)
- Low iron (18.3 ug/dl)
- Very high factor VIII (more than 250%)
- Low Hemoglobin (8.6 gm%)
- Low Hematocrit (PCV) (30.2 vol%)
- High neutrophils (79%)
- Low lymphocytes (12%)
- Blurred vision
- Mild headaches
- Multiple brain strokes within the past month
- Sudden spikes in blood pressure (165/100)
- Memory lapses
- Motion sickness
- Irregular periods, possibly early menopause (age: 43, weight: 48 kg, height: 5 feet 2 inches)
- Previous ovarian cyst removal surgery with high FSH levels
- Recent ankle bone fracture and immobilization

Additionally, her recent MRI scans revealed the following:

- Patchy and confluent hyperintense areas on T2WI and FLAIR imaging with diffusion restriction on DWI / ADC seen in bilateral occipital lobes and posterior parietal lobes,
- Bilateral cerebellar hemispheres
- Splenium of corpus callosum
- Left thalamus

These findings are suggestive of acute infarcts in bilateral PCA (Posterior Cerebral Artery) territory.

Furthermore, there is a significant family history of hypertension, with our father experiencing a brain stroke at the age of 51. He had memory loss and was under the influence of alcohol and strong painkillers at the time. Our father's sister also passed away due to hypertension-related complications.

In terms of medications, during her ankle bone fracture, she was prescribed the following:
1. Calcitrol, calcium citrate Maleate zinc and magnesium and zinc softgel capsule (Mewacal-CT)
2. Aceclofenac + Paracetamol + Trypsin Chymotrypsin (Haysin)
3. Naproxen + Domperidone (Zerograin-Plus New Tablet)
4. Aceclofenac + Paracetamol (Aceclo Plus Tablet)
5. Pantoprazole (Prozole)

Currently, she is on the following medications:
1. Telmisartan 40mg and hydroChlorothiaZide
2. Betahisdine tablet 16mg
3. Ecosprin 325 mg
4. Clopidogrel 75 mg
5. Rosuvastatin 40 mg
6. Ferrous ascorbate, folic acid, cynoco alamin, zinc sulphate monohydrate
7. Pentoprazol sodium 40 mg
8. Methylcobalamine, vitamin D3, calcium carbonate, alpha lipoic acid, inositol, chromium picolinate, folic acid, benfolamine tablets
9. Piracitam 800mg and citicoline 500mg

Despite this extensive information and the list of medications, doctors haven't been able to identify the root cause. Has anyone experienced similar symptoms or have insights into possible underlying conditions? We would greatly appreciate any advice or suggestions for further evaluation and management.

Thank you for your help.