Stroke is a cerebrovascular accident to a part of brain that leads to brain injury and could be hemorrhagic or ischemic of type. It is a medical emergency that needs prompt treatment. Stroke is commonly caused in patients with risk factors like Obesity, Diabetes, Hypertension, dyslipidemias, cardiac disease, alcohol consumption, illicit drug use, sedentary life style or with a family history of stroke. Cirrhosis is a rare cause of ischemic stroke. Studies show that HBV has a protective role in preventing stroke. More studies show HCV related DCLD with hemorrhagic stroke. In our case study, patient was HBV superinfected with HDV infection developed DCLD and had anticoagulant state and he developed ischemic without another risk factors. MRI Brain and MRS showed bilateral multiple infarcts. Patient however could not be given antiplatelet due to high INR and low platelet count. Patient deteriorated over next two days and collapsed but couldn't be revived.
