title: Ischemic stroke associated with activated protein C resistance and aortic valvular papillary fibroelastoma.
abstract: We report an unusual case of a pontine ischemic stroke associated with activated protein C resistance as well as an embolic source in the form of a cardiac valvular lesion. A 31-year-old man had a sudden onset of right hemiparesis and a severe dysarthria. Cranial magnetic resonance imaging (MRI) showed a nonhemorrhagic pontine lesion with essentially negative craniocervical MR angiography. His transesophageal echocardiogram showed a papillary fibroelastoma on the aortic valve. His laboratory studies showed significant activated protein C resistance at 1.7 (normal, >2.1). Other laboratory parameters, including sedimentation rate, were unremarkable. This case suggests that activated protein C resistance may serve as a cofactor in some cases of ischemic stroke, particularly stroke associated with emboligenic cardiac lesions.
authors: Department of Neurology University of Wisconsin Medical School, Madison, WI USA; Section of Cardiology, Department of Medicine, University of Wisconsin Medical School, Madison, WI USA.
authors: D A
authors: DA
authors: Dulli
authors: H S
authors: HS
authors: Schutta
authors: R L
authors: RL
authors: Levine
authors: P S
authors: PS
authors: Rahko