{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T14:31:58Z","timestamp":1790951518267,"version":"4.1.0"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T00:00:00Z","timestamp":1702252800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T00:00:00Z","timestamp":1702252800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Youth Program of National Natural Science Foundation of the Hunan Province","award":["2022JJ40688"],"award-info":[{"award-number":["2022JJ40688"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Neurol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Thrombotic thrombocytopenic purpura (TTP) is a rare and fatal thrombotic microangiopathy-based hematologic disease. Stroke has been reported as atypical neurological manifestations of TTP in some cases.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 65-year-old male presented with typical acute ischemic stroke symptoms including sudden-onset dysarthria, right-sided facial paralysis and hemiplegia. However, his CT and MRI scans were negative without showing any new ischemic lesions. He was diagnosed with TTP with severe thrombocytopenia, mild anemia, increased LDH, and low ADAMTS-13 activity. The symptoms and positive signs were rapidly resolved after administrating the plasma exchange therapy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Clinicians should consider the possibility of TTP when a patient presents with acute stroke-like symptoms and thrombocytopenia, especially in an emergency room, either with or without new stroke lesions on the brain CT and MRI.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12883-023-03489-9","type":"journal-article","created":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T09:02:29Z","timestamp":1702285349000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Thrombotic thrombocytopenic purpura presenting as stroke mimics with normal diffusion-weighted MRI"],"prefix":"10.1186","volume":"23","author":[{"given":"Ziyi","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miao","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,12,11]]},"reference":[{"issue":"21","key":"3489_CR1","doi-asserted-by":"publisher","first-page":"2836","DOI":"10.1182\/blood-2016-10-709857","volume":"129","author":"BS Joly","year":"2017","unstructured":"Joly BS, Coppo P, Veyradier A. Thrombotic thrombocytopenic purpura. Blood. 2017;129(21):2836\u201346.","journal-title":"Blood"},{"issue":"11","key":"3489_CR2","doi-asserted-by":"publisher","first-page":"3163","DOI":"10.1016\/j.jstrokecerebrovasdis.2018.07.017","volume":"27","author":"C Tomich","year":"2018","unstructured":"Tomich C, Debruxelles S, Delmas Y, Sagnier S, Poli M, Olindo S, Renou P, Rouanet F, Sibon I. Immune-Thrombotic Thrombocytopenic Purpura is a Rare cause of ischemic Stroke in young adults: Case Reports and Literature Review. J Stroke Cerebrovasc Dis. 2018;27(11):3163\u201371.","journal-title":"J Stroke Cerebrovasc Dis"},{"issue":"47","key":"3489_CR3","doi-asserted-by":"publisher","first-page":"E1306","DOI":"10.1503\/cmaj.190981","volume":"191","author":"CJ Doig","year":"2019","unstructured":"Doig CJ, Girard L, Jenkins D. Thrombotic thrombocytopenic purpura masquerading as a Stroke in a young man. CMAJ. 2019;191(47):E1306\u20139.","journal-title":"CMAJ"},{"issue":"49","key":"3489_CR4","doi-asserted-by":"publisher","first-page":"e31851","DOI":"10.1097\/MD.0000000000031851","volume":"101","author":"H Zhu","year":"2022","unstructured":"Zhu H, Liu JY. Thrombotic thrombocytopenic purpura with neurological impairment: a review. Med (Baltim). 2022;101(49):e31851.","journal-title":"Med (Baltim)"},{"issue":"1","key":"3489_CR5","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1212\/WNL.0b013e3181aaea1b","volume":"73","author":"TM Burrus","year":"2009","unstructured":"Burrus TM, Wijdicks EF, Rabinstein AA. Brain lesions are most often reversible in acute thrombotic thrombocytopenic purpura. Neurology. 2009;73(1):66\u201370.","journal-title":"Neurology"},{"issue":"5","key":"3489_CR6","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1111\/bjh.18127","volume":"197","author":"RJ Shaw","year":"2022","unstructured":"Shaw RJ, Dutt T. Mind and matter: the neurological Complications of thrombotic thrombocytopenic purpura. Br J Haematol. 2022;197(5):529\u201338.","journal-title":"Br J Haematol"},{"issue":"5","key":"3489_CR7","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1111\/j.1365-2141.2008.07276.x","volume":"142","author":"M Scully","year":"2008","unstructured":"Scully M, Yarranton H, Liesner R, Cavenagh J, Hunt B, Benjamin S, Bevan D, Mackie I, Machin S. Regional UK TTP registry: correlation with laboratory ADAMTS 13 analysis and clinical features. Br J Haematol. 2008;142(5):819\u201326.","journal-title":"Br J Haematol"},{"key":"3489_CR8","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1016\/j.jocn.2021.09.025","volume":"93","author":"M Pohl","year":"2021","unstructured":"Pohl M, Hesszenberger D, Kapus K, Meszaros J, Feher A, Varadi I, Pusch G, Fejes E, Tibold A, Feher G. Ischemic Stroke mimics: a comprehensive review. J Clin Neurosci. 2021;93:174\u201382.","journal-title":"J Clin Neurosci"},{"issue":"4","key":"3489_CR9","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1016\/j.jstrokecerebrovasdis.2011.09.012","volume":"22","author":"N El Husseini","year":"2013","unstructured":"El Husseini N, Goldstein LB. Code Stroke: hospitalized versus emergency department patients. J Stroke Cerebrovasc Dis. 2013;22(4):345\u20138.","journal-title":"J Stroke Cerebrovasc Dis"},{"issue":"3","key":"3489_CR10","first-page":"213","volume":"8","author":"M Hosseininezhad","year":"2017","unstructured":"Hosseininezhad M, Sohrabnejad R. Stroke mimics in patients with clinical signs of Stroke. Casp J Intern Med. 2017;8(3):213\u20136.","journal-title":"Casp J Intern Med"},{"issue":"8","key":"3489_CR11","doi-asserted-by":"publisher","first-page":"e522","DOI":"10.1016\/j.jstrokecerebrovasdis.2013.05.029","volume":"22","author":"A Kose","year":"2013","unstructured":"Kose A, Inal T, Armagan E, Kiyak R, Demir AB. Conditions that mimic Stroke in elderly patients admitted to the emergency department. J Stroke Cerebrovasc Dis. 2013;22(8):e522\u2013527.","journal-title":"J Stroke Cerebrovasc Dis"}],"container-title":["BMC Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-023-03489-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12883-023-03489-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-023-03489-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T09:06:27Z","timestamp":1702285587000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcneurol.biomedcentral.com\/articles\/10.1186\/s12883-023-03489-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,11]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["3489"],"URL":"https:\/\/doi.org\/10.1186\/s12883-023-03489-9","relation":{},"ISSN":["1471-2377"],"issn-type":[{"value":"1471-2377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,11]]},"assertion":[{"value":"17 August 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 December 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 December 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that that the study complies with the ethical requirements of the Second Xiangya Hospital. The Ethics Committee of the Second Xiangya Hospital has confirmed that ethical approval is not required for a case report. Informed parental consents to participate were obtained from the individual included in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written and signed parental consent to publish this information was obtained from the individual included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"435"}}