Hypercoagulability and Ischemic Stroke in Young Patients

Abstract

Introduction: Hypercoagulable states have been reported as a predisposing factorfor ischemic stroke, especially among young patients. This may haveimplications on therapeutic management and secondary prevention. We have studied the frequency of prothrombotic abnormalities in young patients with ischaemic stroke, as other classic risk factors are less common in this group. Materials and methods: All patients under 50 with ischemic stroke admitted to the Service of Neurology from January 2010 through June 2011were studied. We analysed risk factors, including the presence of hypercoagulable states, and outcome. These patients were prospectively studied. The ESO 2008 diagnostic criteria for ischemic stroke are used. Titration of natyral anticoagulants was done 7 ± 2 days after cerebral infarction. Besides the routine tests, the following activity tests were performed: protein C, Protein S, homocysteinemia and antithrombin titration. Results: We included 36 patients,under 50 years of age, diagnosed with cerebral infarction of undetermined cause randomly presented to the University Service of Neurology January 2010 – June 2011. There were 16 males (44.4%) with a mean age of 30 years old (23 - 48). The mean age for 20 females (55.6%) was 28 years old (22 - 45). 1 patient (2.7%),hadantithrombin deficiency. Isolated protein S deficiency was detected in 5 cases (13.8%); in 1 case we observed the association between protein S deficiency and antiphospholipid antibodies; protein C deficiency was seen in 2 case ( 5.5%). Conclusions: The hypercoagulable states are common in young patients with ischaemic stroke, so we recommend the screening for hypercoagulable states in all young patients with ischemic stroke. Keywords: ischemic stroke, hyporcoagulable state, prothrombotic abnormalities.