Elevated Factor VIII in the Setting of Recurrent Ischemic Strokes

We report a case of a 52-year-old female who first developed an acute lacunar infarction in the left thalamus. Two and a half years later, the patient presented with a new infarction due to high-grade stenosis of the mid basilar artery, which required treatment with tenecteplase (TNK) and angioplasty with stenting. Approximately one month following this, the patient developed a new pontine infarction despite a patent basilar artery stent. This prompted a hypercoagulable workup, which revealed an elevated factor VIII level.