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Blood Dyscrasias and Stroke

Hematologic Disorders and Stroke

Hematologic abnormalities lead to thrombosis in the cerebral vasculature, causing ischemic cerebrovascular events. However, the majority of patients with ischemic cerebrovascular events do not have a well-defined hematologic abnormality. Coagulation disorders that predispose to strokes remain poorly defined but have been implicated in venous strokes (cerebral venous thrombosis) rather than arterial strokes. Platelet function abnormality, inherited hemostatic abnormality, and vascular injury promote thrombosis.

The aim of this article is to highlight the significance of these factors in stroke, to assess their impact on long-term prognosis, and to outline an approach to the patient with stroke for evaluation of hemostatic abnormalities. The specific factors discussed in this article include factor V Leiden (ie, resistance to activated protein C [APC]
), deficiencies of proteins C and S
and antithrombin III, sickle cell anemia, hyperhomocystinemia, antiphospholipid syndrome (APS), hereditary disorders of fibrinolysis, and certain acquired conditions leading to abnormal platelet function and hypercoagulable state.

For patient education information, see eMedicineHealth’s Brain and Nervous System Center and Stroke.

Go to Medscape Reference articles Ischemic Stroke, Acute Management of Stroke, Platelet Disorders, and Nonplatelet Hemostatic Disorders for more information on these topics.

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