[Brain infarct due to non-bacterial thrombotic valvular vegetation associated with primary antiphospholipid...

A 50-year-old woman with antiphospholipid antibody syndrome (APAS) awoke in a morning to notice dizziness, so she came to our hospital. Several hours later she developed left oculomotor paralysis. Further two hours later she developed right oculomotor paralysis and could not stand. Brain MRI showed high signal intensity lesion of paramedian thalamic and midbrain on the T2-weighted image. Cerebral angiography did not reveal any occlusion. Transesophageal echocardiography disclosed mitral valvular vegetation. We thought this valvular abnormality was non-bacterial thrombotic vegetation associated with APAS and this suggests that cerebral infarction was due to emboli from this vegetation.