Antiphospholipid antibodies in patients without systemic lupus erythematosus: neuroradiologic findings.
OBJECTIVE
To study neuroradiologic findings in patients with hypercoagulability due to antiphospholipid antibodies (APAs).


METHODS
Retrospective review of abnormal angiographic, computed tomographic, and magnetic resonance imaging findings was performed over a 14-month period in patients with APAs, no diagnosis of systemic lupus erythematosus, age less than 65 years, and no other cause of a hypercoagulable state.


RESULTS
Fourteen patients (age range, 22-62 years) with APAs had abnormal results at neuroradiologic examination. Abnormal findings on cross-sectional imaging studies included large-artery (n = 3), lacunar (n = 5), and venous infarctions (n = 2); cortical atrophy (n = 5); white matter abnormalities (n = 3); and dural sinus thrombosis (n = 4). Abnormal angiographic findings included large-artery occlusions (n = 2), arterial narrowing that simulated vasculitis (n = 2), and transverse sinus thrombosis (n = 1).


CONCLUSIONS
Presence of APAs should be suspected when no cause is apparent for either (a) an ischemic cerebrovascular event in young and middle-aged adults or (b) dural sinus or cerebral venous thrombosis (c) in patients with recurrent systemic arterial or venous thromboses, especially women with recurrent miscarriages.
Department of Radiology, Duke University Medical Center, Durham, NC 27710.
J M
JM
Provenzale
E R
ER
Heinz
T L
TL
Ortel
B G
BG
Macik
L A
LA
Charles
M J
MJ
Alberts
D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000032:analysis*; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology; D001927:Brain Diseases / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000000981:diagnostic imaging* / Q000276:immunology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D017152:Antibodies, Antiphospholipid