Lysis and thrombosis: Manifestation of the same disease

A 19-year-old female patient presented to the emergency department 6 hr after an episode of headache followed by brief loss of consciousness. The episode was associated with jerking of extremities and rapid recovery was reported without confusion or focal neurologic deficit. She reported having tension-like headaches for several months. She denied any fever, chills, nausea, vomiting, or head trauma. Physical examination revealed an obese, pale patient with flat affect. Her temperature was 99°F, pulse: 90 beats per minute, and blood pressure 110/75 mmHg without evidence of orthostasis. Neurological examination was pertinent for right Babinski sign. Her initial complete blood count revealed hemoglobin: 6.0 g/dL, hematocrit: 18%, MCV: 91.8 fl, platelet count: 116 × 10³ per microliter, and leukocyte count: 6,700 per microliter.