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August 19, 2026The Neurohospitalist

Thrombotic Thrombocytopenic Purpura Causing Multiple Large Vessel Occlusions: A Case Report

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Authors

MMMeg B. McCalleyXZXueqing ZhangAVAlexander Vorobyev

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Overview

Case report reveals recurrent large vessel occlusions from thrombotic thrombocytopenic purpura in a young female, highlighting the need to test ADAMTS13 in cryptogenic strokes.

Key Points

  • To describe a rare presentation of thrombotic thrombocytopenic purpura (TTP) manifesting as acute ischemic stroke with recurrent large vessel occlusions.
  • Clinical and diagnostic evaluation of a 29-year-old female presenting with acute ischemic stroke and subtle fluctuating thrombocytopenia.
  • Treatment and monitoring involving mechanical thrombectomy, plasma exchange, high-dose corticosteroids, and rituximab.
  • Mechanical thrombectomy demonstrated rapid, recurrent intraprocedural clot formation associated with nonbacterial thrombotic endocarditis and severely deficient ADAMTS13 enzyme activity.
  • Therapy with plasma exchange, corticosteroids, and rituximab resolved the hematologic deficiency and prevented further ischemic events during follow-up.

Cite This Study

McCalley et al. (2026) studied this question.

synapsesocial.com/papers/6a85637603308d306e2d69bdhttps://doi.org/10.1177/19418744261475525
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1C51-13 Pursuing a Rare Diagnosis: Thrombotic Thrombocytopenic Purpura Causing Stroke-like Symptoms2026
  2. 2Acute large vessel occlusion stroke as a neurovascular complication of immune thrombotic thrombocytopenic purpura: Mechanical thrombectomy and neurocritical care challenges2026
  3. 3Progression From Early Multiterritorial Punctate Infarcts to Massive Stroke in Fulminant Thrombotic Thrombocytopenic Purpura Despite Aggressive Therapy: A Therapeutic Dilemma in Initiating Antithrombotic Therapy2025
  4. 4A clever stroke mimic: thrombotic thrombocytopenic purpura without schistocytes – a case report and literature review2025
  5. 5C51-14 A Case of Idiopathic Thrombotic Thrombocytopenia Purpura With Suspected Myositis2026