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Case Reports
. 2024 Jul 24;16(7):e65243.
doi: 10.7759/cureus.65243. eCollection 2024 Jul.

Patterns of Cerebrovascular Accidents in Antiphospholipid Syndrome

Uthayanila Pandian  1 , Arun K  2 , Raji Rajesh Lenin  3 , Ajay Dev  1 , J S Kumar  1
Affiliations
Case Reports

Patterns of Cerebrovascular Accidents in Antiphospholipid Syndrome

Uthayanila Pandian et al. Cureus. .

Abstract

Antiphospholipid syndrome (APS) is an autoimmune disease that primarily affects young adults. It is characterized by the development of antiphospholipid antibodies (APL) and a wide range of macro- and microvascular symptoms. The primary causes of morbidity and mortality in APS are cardiovascular events. Subclinical atherosclerosis and cardiovascular events are associated with high-risk APL profiles, particularly with the presence of lupus anticoagulant and triple APL positivity (all three APL subtypes), co-existence with systemic lupus erythematosus (SLE), and traditional risk factors like smoking, hypertension, obesity, and hyperlipemia. We present a case series involving three female stroke patients with APS. This series highlights the importance of immunological profiles in all stroke patients.

Keywords: antiphospholipid syndrome; cerebro vascular accidents; facial palsy; transesophageal echo; young stroke.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. MRI brain and TOE findings
1A: MRI brain showing diffusion restriction in right frontal and parietal region suggestive of acute infarct. 1B: MRI brain showing low ADC suggestive of acute infarct in right frontal and parietal region. 1C: TOE showing verrucous mass under the surface of PML with absent independent motion ADC: apparent diffusion coefficient; MRI: magnetic resonance imaging; PML: posterior mitral leaflet; TOE: transoesophageal echocardiogram
Figure 2
Figure 2. MRI brain findings
2A: MRI brain T2 FLAIR showing heterogeneously hyperintense area involving cortical and subcortical regions of the right parieto-occipital region. 2B: MRI brain SWI showing blooming suggestive of hemorrhagic venous infarct in the same area FLAIR: fluid-attenuated inversion recovery; MRI: magnetic resonance imaging; SWI: susceptibility-weighted imaging
Figure 3
Figure 3. Diffusion-weighted MRI showing hyperintense foci at the junction of left lateral pontine tegmentum and left middle cerebellar peduncle
MRI: magnetic resonance imaging
See this image and copyright information in PMC

References

    1. Stroke and antiphospholipid syndrome: the treatment debate. Ruiz-Irastorza G, Khamashta MA. Rheumatology (Oxford) 2005;44:971–974. - PubMed
    1. The antiphospholipid syndrome: still an enigma. Chaturvedi S, McCrae KR. Hematology Am Soc Hematol Educ Program. 2015;2015:53–60. - PMC - PubMed
    1. Neurologic manifestations of the antiphospholipid syndrome - an update. Leal Rato M, Bandeira M, Romão VC, Aguiar de Sousa D. Curr Neurol Neurosci Rep. 2021;21:41. - PMC - PubMed
    1. Pathophysiology and treatment of stroke: Present status and future perspectives. Kuriakose D, Xiao Z. Int J Mol Sci. 2020;21:42–44. - PMC - PubMed
    1. Stroke and risk factors in antiphospholipid syndrome. Fan Y, Xu Y, Zhang S, Song X, Liu Z, Tu W, Li C. J Pers Med. 2023;14:26–28. - PMC - PubMed

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