[Ischemic stroke at the young age: the role of antiphospholipid antibodies]

Output of antiphospholipid antibodies (aPL) coupled with arterial and/or venous thromboses, miscarriage and some other clinical manifestations is denoted as antiphospholipid syndrome (APS). The syndrome is primary (PAPS) in the absence of other autoimmune diseases. Arterial thromboses occur most frequently in the cerebral arteries, leading to ischemic disorders of cerebral circulation (DCC). The present work summarises the results of our own studies and of the reported data on DCC in PAPS. Their characteristic features Include the relationship with occlusion of the intracerebral or intracranial rather than of the great vessels of the head, liability for recurrences in the absence of secondary prophylaxis, frequently occurring association with primary disorder of cerebral circulation (PDCC), good restoration of the focal neurologic deficit after the first stroke, more frequent development in women. The clinical recognition of DCC which stem from aPL output is favoured by the presence in the patients of the basic non-cerebral signs of PAPS (miscarriage peripheral venous thrombosis, myocardial infarction) as well as by the presence of the additional evidence of PAPS (livedo, induration of heart valves according to the EchoCG data, epileptic syndrome, migraine-like headaches, chorea in the anamnesis, and so forth). In most cases, they precede the first DCC by several years or months. The secondary prophylaxis of DCC in PAPS includes the intake of indirect anticoagulants and. small doses of aspirin.