Ischemic Stroke as the Presenting Feature for Non‐acute Promyelocytic Leukemia Variant of Acute Myeloid Leukemia: A Case Report

Acute myeloid leukemia (AML) patients encounter complications mainly due to their underlying disease or chemotherapy. Although they are at high risk for both hemorrhagic and thrombotic complications, vascular complication as an initial manifestation is less common rarely reported, especially in non-acute promyelocytic (non-APML). A 58-year-old female with no co-morbidity presented fever, decreased appetite, headache, weakness her left upper lower limbs. Laboratory findings showed hyperleukocytosis 90% blast cells thrombocytopenia (50,000/dl). While investigated conservatively managed, she developed a seizure loss of consciousness on the same day was admitted intensive care unit. Computed tomography massive right infarct middle cerebral artery territory significant midline shift. Flow cytometry indicated diagnosis non-APML; chemotherapy, platelet transfusion, unfractionated heparin, mechanical ventilation, other supportive treatments were started. managing this case, we faced challenges decision-making thrombolysis, craniotomy, The case highlights salient points dilemmas such acutely ill patient critical care.