title: Hepatitis C and recurrent treatment-resistant acute ischemic stroke.
abstract: Since the introduction of recombinant tissue plasminogen activator and thrombolysis, acute ischemic stroke has become a treatable disorder if the patient presents within the 4.5-hour time window. Typically, sporadic stroke is caused by atherosclerotic disease involving large or small cerebral arteries or secondary to a cardioembolic source often associated with atrial fibrillation. In the over-65-year age group, more rare causes of stroke, such as antiphospholipid syndromes, are unusual; such stroke etiologies are mostly seen in a younger age group (<55 years). Here we describe acute ischemic stroke in three patients >65 years with hepatitis C-associated antiphospholipid antibodies. We suggest that screening for antiphospholipid disorders in the older patient might be warranted, with potential implications for therapeutic management and secondary stroke prevention.
authors.affiliation: Department of Neurology (Saxsena, Tarsia, Dunn, Aysenne) and Department of Radiology (Shah), Tulane University Medical Center, New Orleans, Louisiana; and the Baylor Neuroscience Center, Baylor University Medical Center at Dallas (Moore).
authors.forename: Aneeta
authors.initials: A
authors.lastname: Saxsena
authors.forename: Joseph
authors.initials: J
authors.lastname: Tarsia
authors.forename: Casey
authors.initials: C
authors.lastname: Dunn
authors.forename: Aimee
authors.initials: A
authors.lastname: Aysenne
authors.forename: Basil
authors.initials: B
authors.lastname: Shah
authors.forename: David F
authors.initials: DF
authors.lastname: Moore
references.citation: Rom J Intern Med. 2005;43(1-2):89-95
references.pmid: 16739869
references.citation: Rev Neurol (Paris). 2006 Nov;162(11):1131-4
references.pmid: 17086152
references.citation: Neurology. 1993 May;43(5):1021-7
references.pmid: 8492920
references.citation: J Clin Gastroenterol. 1997 Jan;24(1):40-2
references.pmid: 9013350