Stroke in Hyperparathyroidism

Twelve patients with signs and symptoms indicative of major stroke and five patients who had suffered from syncope and other signs of minor stroke were found to have coexistent hyperparathyroidism (HPT) when admitted to hospital as emergency cases. The mean age of the former group, consisting of three males and nine females, was 69.7 years (range 53–84). The mean age of the second group, two males and three females, was 66 years (range 56–84). Fourteen patients were operated on. In ten of them parathyroid adenoma was found, in three primary parathyroid hyperplasia, in one parathyroid cancer. Three patients died before parathyroid exploration could be undertaken. Parathyroid adenomas were revealed at autopsy. Of the operated patients one died of a new stroke 1 month after operation and another of metastasis of parathyroid cancer. The neurological and mental condition of all the 12 surviving patients improved. The possible relation between the development of signs of major or minor stroke and HPT is discussed. The importance of normalization of the parathyroid function in these patients, in order to facilitate the rehabilitation of the patients with major stroke, is stressed. In patients with minor stroke and HPT early operation might prevent development of major stroke.