title: Hematologic abnormalities occur in both cortical and lacunar infarction.
abstract: OBJECTIVE
  Primary hematologic abnormalities are a rare but established cause of ischemic stroke. In addition, activation of hemostatic parameters is often present during the acute phase of stroke. However, it is uncertain whether these abnormalities occur in both cortical and lacunar infarction; this study aimed to further assess this issue.
  
  
  METHODS
  Hematologic parameters (prothrombin, activated partial thromboplastin, thrombin clotting, and euglobulin lysis times; and fibrinogen, fibrinopeptide A, antithrombin III, protein C, protein S, and plasminogen levels) were measured in 19 patients within 48 hours of the onset of acute cerebral infarction. These patients included 10 with cortical infarcts and 9 with lacunar infarcts, as determined by standard clinical and radiological criteria.
  
  
  RESULTS
  Five patients with lacunar infarction and 7 patients with cortical infarction demonstrated raised fibrinopeptide A levels, indicating enhanced thrombin activity. Fibrinolysis, assessed by the euglobulin lysis time, was impaired in 6 of 9 patients with lacunar infarction and in 2 of 10 patients with cortical infarction. Lupus anticoagulants were detected in 3 patients with lacunar infarction and in 1 patient with cortical infarction. Three patients in each group displayed decreased antithrombin III function, and 1 patient with a lacunar infarction had a low protein C level.
  
  
  CONCLUSIONS
  Primary hematologic disorders and secondary hemostatic derangements may occur in patients with either cortical or lacunar infarction.
authors.affiliation: Department of Neurology, Royal Melbourne Hospital, Victoria, Australia.
authors.forename: T J
authors.initials: TJ
authors.lastname: Kilpatrick
authors.forename: Z
authors.initials: Z
authors.lastname: Matkovic
authors.forename: S M
authors.initials: SM
authors.lastname: Davis
authors.forename: C M
authors.initials: CM
authors.lastname: McGrath
authors.forename: R J
authors.initials: RJ
authors.lastname: Dauer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001777:Blood Coagulation; D002545:Brain Ischemia / Q000097:blood* / Q000209:etiology; D002540:Cerebral Cortex / Q000098:blood supply; D002544:Cerebral Infarction / Q000097:blood* / Q000209:etiology; D048909:Diabetes Complications; D005260:Female; D006487:Hemostasis; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking