Screening for coagulation disorders in patients with ischemic stroke.
The role of coagulation disorders in the pathogenesis of (recurrent) ischemic stroke is uncertain. Therefore, the clinical utility of screening patients with ischemic stroke for these conditions and the therapeutic implications of a detected coagulation disorder in a patient who experienced ischemic stroke are uncertain. We reviewed the currently available data on the relationship between various inherited and acquired coagulation abnormalities (factor V Leiden and prothrombin G20210A mutations, deficiencies of protein C, protein S and anti-thrombin, hyperhomocysteinemia, the antiphospholipid syndrome and increased levels of fibrinogen) and ischemic stroke. Based on the existing evidence we discuss the usefulness of screening stroke patients for prothrombotic conditions and current recommendations regarding the optimal management of ischemic stroke patients in whom a coagulation disorder is found.
de Lau
Lonneke Ml
LM
Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands. l.delau@erasmusmc.nl
Leebeek
Frank Wg
FW
de Maat
Moniek Pm
MP
Koudstaal
Peter J
PJ
Dippel
Diederik Wj
DW
D000328:Adult; D000367:Age Factors; D001778:Blood Coagulation Disorders / Q000097:blood / Q000150:complications* / Q000175:diagnosis* / Q000235:genetics / Q000503:physiopathology; D002545:Brain Ischemia / Q000097:blood / Q000209:etiology* / Q000235:genetics / Q000503:physiopathology; D002648:Child; D005165:Factor V / Q000235:genetics; D005260:Female; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications / Q000175:diagnosis; D008403:Mass Screening; D020151:Protein C Deficiency / Q000150:complications / Q000175:diagnosis; D018455:Protein S Deficiency / Q000150:complications / Q000175:diagnosis; D011516:Prothrombin / Q000235:genetics; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000097:blood / Q000209:etiology* / Q000235:genetics / Q000503:physiopathology*; D019851:Thrombophilia / Q000150:complications / Q000175:diagnosis
C095381:factor V Leiden; D005165:Factor V; D011516:Prothrombin