# Polycythemia Vera Presenting As Acute Non-hemorrhagic Infarction and Chronic Bleed: Deception Between the Lines

## TL;DR

A patient with polycythemia vera showed signs of both a stroke and chronic bleeding, highlighting the complex complications of the disease.

## Contribution

This case report highlights an unusual presentation of polycythemia vera with both ischemic and hemorrhagic features.

## Key findings

- A patient with polycythemia vera presented with acute lacunar infarcts and chronic bleed changes.
- The patient's CBC and hematocrit results were consistent with PV, and the JAK2 genetic marker was positive.

## Abstract

Patients with polycythemia vera (PV) develop various complications due to hyper-viscous blood, causing events such as ischemic stroke. There are other associated complications due to the dysfunction of platelet activity, causing hemorrhages. In our unusual case, we present a patient who came to the OPD complaining of slurring speech. An MRI was done and was suggestive of acute lacunar infarcts with changes in chronic bleed. CBC and hematocrit were consistent for PV, with the genetic marker JAK2 being positive.