Pseudoaneurysm Detected in Stroke Patient with Acquired Hemophilia: case report

ABSTRACT

Pseudoaneurysm arises from disruption in arterial wall continuity resulting from inflammation, trauma or iatrogenic cause. Stroke patient with pseudoaneurysm during rehabilitation has not been reported yet. A 62-year-old man who participated in comprehensive rehabilitation program after stroke presented with right thigh swelling and pain. On physical examination, non-pulsatile tender and broad mass was palpated in the lateral region of right lower thigh. A 2.7 cm-sized pseudoaneurysm in right vastus muscle was identified by a duplex ultrasonography and enhanced CT-angiogram. The patient was successfully treated with ultrasonography-guided thrombin injection and embolization. At this time, laboratory test revealed prolongation of aPTT, undetectable factor VIII levels and the presence of the factor VIII antibody, which made the diagnosis of acquired hemophilia A. The patient was discharged 7 weeks later. We report a case of pseudoaneurysm during rehabilitation program in hemiplegic patient with acquired hemophilia A.