Cerebral infarction associated with adenomyosis: Two case reports with mechanistic insights and multidisciplinary management

Shan Jiang, Liuqing Yang, Jiaqi Wen, Yuanyuan Cao, Wanting Ji, Wenjun Ji, Zanhui Jia
Medicine · 2025 · vol. 104(42) , pp. e45294 · doi:10.1097/md.0000000000045294 · PMID:41189148 · W4415918620
article OA: gold CC0
🔓 Open OA copy View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This report details two cases of cerebral infarction associated with adenomyosis and abnormal uterine bleeding, exploring a proposed pathogenesis and emphasizing a multidisciplinary management approach, with hysterectomy as the most effective strategy to prevent recurrence.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

RATIONALE: Benign gynecological disorders causing abnormal uterine bleeding (AUB), such as adenomyosis, may trigger recurrent thrombosis similar to Trousseau syndrome. Trousseau syndrome is characterized by recurrent thrombotic events in patients with malignant tumors. We report 2 patients with adenomyosis who experienced recurrent cerebral infarction (CI) associated with AUB, exploring the mechanistic insights and highlighting a multidisciplinary approach to treatment. PATIENT CONCERNS: One patient suffered 2 episodes of AUB and CI, following repeated failure of conservative therapies. The other patient experienced 3 CI events on the second day of menstruation. DIAGNOSES: Both patients were diagnosed with adenomyosis complicated by CI. INTERVENTIONS: The first patient underwent conservative treatments, including gonadotropin-releasing hormone agonist, uterine curettage, and levonorgestrel-releasing intrauterine system insertion. The second patient received uterine artery embolization to suppress menstruation, followed by continuous gonadotropin-releasing hormone agonist therapy. Both patients received neuroprotective therapy to stabilize neurological symptoms. OUTCOMES: Both patients experienced temporary relief of AUB and neurological symptoms after each episode with conservative treatment. As of now, Patient 1 has experienced multiple episodes of symptom recurrence despite conservative treatment failures and has declined hysterectomy, while Patient 2 has not had any further recurrence. LESSONS: This report highlights the multifactorial pathogenesis of adenomyosis complicated by CI, emphasizing the shared pathway of hypercoagulability, endothelial injury, thrombus formation, and embolic migration. A multidisciplinary, staged management approach is crucial, with acute-phase focus on reperfusion therapy and AUB control, followed by conservative treatments or hysterectomy for long-term management. Neuroprotection and the management of comorbidities are integral throughout. Hysterectomy remains the most effective strategy to prevent recurrence. The proposed framework provides evidence-based guidance for managing these complex cases, with implications for clinical practice and future research.

My notes (saved in your browser only)

Condition tags

adenomyosis

MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (49)

Source provenance

europepmc
last seen: 2026-06-04T01:30:01.192114+00:00
openalex
last seen: 2026-06-04T00:00:01.174412+00:00
pmc
last seen: 2026-05-13T20:22:03.195721+00:00
pubmed
last seen: 2026-05-30T00:30:57.342446+00:00
License: CC0 · commercial use OK