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Orsucci et al. Neuroimmunol Neuroinflammation 2018;5:6 I http://dx.doi.org/10.20517/2347-8659.2017.66 Page 3 of 4
A B
C D
E F
Figure 1. Recurrent strokes and fetal-type PCA in our patient. (A, B) Right mesial frontal ischemic stroke at age 40 years, and its 6-month
evolution (FLAIR axial MRI images); (C, D) acute ischemic lesion in the right temporo-parietal-occipital regions at age 41 years (diffusion-
weighted and FLAIR axial MRI images); (E, F) two consecutive angiograms (at the time of the first stroke and after 6 months) showing the
fetal-type right PCA, originating from the right internal carotid artery. PCA: posterior cerebral artery; MRI: magnetic resonance imaging
DISCUSSION
To our knowledge, this is the first report of an heterozygous fibrinogen mutation in a young patient with
recurrent TIAs and strokes. Further studies are needed to better elucidate the links between fibrinogen
function (and dysfunction) and ischemic stroke. It is likely other genetic and/or environmental factors may
have a role.
From this perspective, an intriguing observation is the lateralization of all the TIAs and strokes of our
patient in the right hemisphere (in the presence of a right fetal-type PCA). Even if the association between
