# Acute Ischemic Stroke Secondary to Severe Anemia From Upper Gastrointestinal Bleeding: A Case Report

## TL;DR

A 63-year-old man with severe anemia from a stomach ulcer suffered an ischemic stroke, highlighting the link between low blood volume and stroke risk.

## Contribution

This case report demonstrates anemia as a critical, often overlooked contributor to ischemic stroke.

## Key findings

- Severe anemia from upper gastrointestinal bleeding led to hypovolemia and ischemic stroke.
- Blood transfusions and clopidogrel improved patient outcomes.
- Anemia's role in stroke highlights the need for early detection and treatment.

## Abstract

Anemia is increasingly recognized as a significant risk factor for ischemic stroke, contributing to cerebral hypoperfusion and exacerbating cerebrovascular events. This case report highlights the complex interplay between severe anemia and ischemic stroke in a 63-year-old male with a history of well-controlled hypertension and type 2 diabetes mellitus. The patient presented with acute neurological deficits, including slurred speech and left-sided weakness, which were later diagnosed as ischemic stroke. His condition was preceded by upper gastrointestinal bleeding from a pyloric channel ulcer, resulting in severe acute posthemorrhagic anemia and consequent hypovolemia. Anemia, often overlooked as a major stroke risk factor, was identified as a key contributor to the ischemic event. Potential mechanisms include reduced oxygen-carrying capacity, cerebral hypoperfusion due to volume loss, and endothelial dysfunction. Immediate management included blood transfusions to correct the anemia, intravenous proton pump inhibitors for gastrointestinal bleeding control, and clopidogrel for secondary stroke prevention. The patient’s condition improved gradually, underscoring the importance of early recognition and treatment of anemia in stroke patients. This case emphasizes the need for comprehensive management of underlying anemia and cerebrovascular risk factors to optimize patient outcomes.