Science and Education Publishing American Journal of Medical Case Reports 2374-216X 4 5 2016 5 13 In Front of Ischemic Stroke: Think about Pernicious Anemia 158 159 EN Ines Kechaou Internal Medicine Department, University hospital of Charles Nicolle, Tunis, Tunisia Eya Cherif Imene Boukhris Samira Azzabi Chékib Kooli Lamia Ben Hassine Narjes Khalfallah AJMCR2016453 10.12691/ajmcr-4-5-3 2015 12 17 2016 3 10 2016 5 11 Pernicious anemia can cause several neurologic impairment. Ischemic stroke has been reported as a rare complication of pernicious anemia. We report a case of 51-year-old woman, who presented with ischemic stroke. Hyperhomocysteinemia due to pernicious anemia was diagnosed while looking for secondary causes of the cerebral event. She was treated with vitamin B12 that improved her anemia but not her neurological impairment.