Ischemic stroke associated with activated protein C resistance and aortic valvular papillary fibroelastoma.
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.
Dulli
D A
DA
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.
Schutta
H S
HS
Levine
R L
RL
Rahko
P S
PS