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An elderly case with late carotid stent thrombosis: possible role of antiphospholipid antibodies
The case study speculates that the antiphospholipid antibodies acquired during the follow-up period of carotid artery stenting may cause late stent thrombosis that is resistant to direct oral anticoagulants. A 73-year-old man was hospitalized with complaints of weakness in the right lower extremity. The patient had undergone carotid artery stenting for symptomatic stenosis of the left internal carotid artery 6 years prior and had received antiplatelet therapy with clopidogrel 75  mg/day. As the patient had developed atrial fibrillation without stent stenosis at the age of 70 years, anticoagulation therapy with rivaroxaban...
Source: Journal of Stroke and Cerebrovascular Diseases - May 26, 2023 Category: Neurology Authors: Shinji Kitsuki, Kenji Fukuda, Tomonaga Matsushita, Yoshihisa Fukushima, Tetsuro Ago, Takanari Kitazono Tags: Case Report Source Type: research

Extra-criteria antiphospholipid antibodies in patients with small vessel brain lesions and clinical manifestations associated with antiphospholipid syndrome
Antiphospholipid syndrome (APS) – as included in the updated APS classification criteria – is characterized by circulating antibodies (Abs) directed against phospholipid-binding proteins or their complex with phospholipids (aPL) and clinical manifestations of thrombosis or gestational morbidity.1 These criteria are very specif ic to ensure homogeneity for some purposes, such as clinical assays, yet they are not very sensitive for APS diagnosis.2 Due to this lack of sensitivity, clinicians must be aware of some entities – distinct from thrombosis fetal losses, or eclampsia – that are not included in the classificati...
Source: Journal of Stroke and Cerebrovascular Diseases - February 24, 2023 Category: Neurology Authors: Miguel Ángel Estévez, Nallibe Lanio, Águeda Molina, Maria Reyes Jiménez-León, María José Picado, Eva Esteban, Sonia Sánchez, Lucio Pallarés, Maria Rosa Julià Source Type: research

Cerebral Infarction due to Severe ADAMTS-13 Deficiency with Normal Hematological Parameters: A Cause of Cryptogenic Stroke
Stroke is a leading cause of death and disability worldwide, and there are 1.3 million strokes annually in adults less than 50 years old.1 Many of these strokes are cryptogenic, with no clear etiology identified. In this setting clinicians frequently test for rare causes of thrombosis including hyperhomocystinemia, antiphospholipid syndrome, Factor V Leiden, prothrombin gene mutations, and protein C, S or antithrombin deficiency. Thrombotic thrombocytopenic purpura (TTP) causes arterial thrombosis, but is rarely considered in the evaluation of cryptogenic stroke with normal or near-normal hematologic profiles.
Source: Journal of Stroke and Cerebrovascular Diseases - March 16, 2022 Category: Neurology Authors: Andrew Matthews, Jennifer Yui, Elaine Y. Chiang, Allyson M. Pishko, Adam Cuker, Brett L. Cucchiara, Donna George, Farzana Sayani, Michael T. Mullen Tags: Short Communication Source Type: research

Failure of Anticoagulation to Prevent Stroke in Context of Lupus-Associated Anti-Phospholipid Syndrome and Mild COVID-19
We present a 43-year-old female with a history of seropositive-antiphospholipid syndrome and systemic lupus erythematosus who developed an acute ischemic stroke in the setting of mild COVID-19 infection despite adherence to chronic systemic anticoagulation.
Source: Journal of Stroke and Cerebrovascular Diseases - April 12, 2021 Category: Neurology Authors: Keith J. Kincaid, Alexis N. Simpkins Source Type: research

Current Practice and Clinical Utility of Thrombophilia Testing in Hospitalized Patients with Acute Ischemic Stroke
Testing for thrombophilic disorders is often performed in patients after a thrombotic event without a clear etiology, as in cryptogenic acute ischemic stroke (AIS). Although some disorders, notably antiphospholipid antibody syndrome, have a known association with increased arterial thrombotic risk,1 the role of other commonly tested thrombophilic disorders in AIS is not well-quantified.2-5 Furthermore, there are few studies to identify interventions, specifically the use of anticoagulation, to decrease recurrent AIS risk.
Source: Journal of Stroke and Cerebrovascular Diseases - August 18, 2020 Category: Neurology Authors: Jori E. May, Kimberly D. Martin, Laura J. Taylor, Radhika Gangaraju, Chen Lin Source Type: research

Antiphospholipid Syndrome of Late Onset: A Difficult Diagnosis of a Recurrent Embolic Stroke
A 77-year-old woman with atrial fibrillation (AF) treated with warfarin had a cortical left middle cerebral artery (MCA) stroke (October 2009, international normalized ratio [INR], 1.6) and a cortical left frontal stroke (October 2011, INR, 1.9). Anticoagulation was adjusted. In October 2011, she had a right frontal stroke (INR, 2.3). Acetylsalicylic acid (ASA) was temporally added to the treatment. In June 2013, she had a left occipital stroke (INR, 2.3). Warfarin was changed to rivaroxaban. In August 2013, she had a right occipital stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - May 12, 2015 Category: Neurology Authors: Montserrat G. Delgado, Sergio Rodríguez, Raquel García, Pablo Sánchez, Antonio Sáiz, Sergio Calleja Tags: Case Report Source Type: research

Bilateral Central Retinal Artery Occlusion in a Patient with Systemic Lupus Erythematosus
We report a case of a 20-year-old woman with newly diagnosed SLE, who awoke with bilateral simultaneous central retinal artery occlusion (CRAO). Her antiphospholipid antibody panel was normal. Vision did not recover after treatment with steroids and anticoagulation. This case suggests that such patients may be in hypercoagulable status even with negative antiphospholipid antibodies. Severe ocular complication such as CRAO may occur during the early disease process.
Source: Journal of Stroke and Cerebrovascular Diseases - April 20, 2015 Category: Neurology Authors: Li Hua, Ketan Patel, James J. Corbett Tags: Case Report Source Type: research

Clinical and Radiological Management and Outcome of Pregnancies Complicated by Cerebral Venous Thrombosis: A Review of 19 Cases
Conclusions: If magnetic resonance imaging is available, it should be used for the detection of CVT in all pregnant patients instead of computed tomography. Patients with parenchymal lesions, thrombophilia, and antiphospholipid syndrome had a greater risk of being left with neurologic sequelae. For pregnant patients with CVT, low molecular weight heparin in full anticoagulant doses should be continued throughout the pregnancy. Anticoagulant therapy did not appear to predispose patients to further intracranial hemorrhage.
Source: Journal of Stroke and Cerebrovascular Diseases - August 17, 2012 Category: Neurology Authors: Caner Feyzi Demir, Mehmet Fatih İnci, Fuat Özkan, Mustafa Yıldız, Hasan Özdemir Tags: Original Articles Source Type: research