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Hematologic abnormalities occur in both cortical and lacunar infarction
T J Kilpatrick1, Z Matkovic, S M Davis
1Department of Neurology, Royal Melbourne Hospital, Victoria, Australia.
Stroke
|December 1, 1993
Summary
Hematologic abnormalities and hemostatic derangements are common in acute ischemic stroke, affecting both cortical and lacunar infarction types. These findings suggest underlying blood clotting issues contribute to stroke in diverse patient groups.
Area of Science:
- Neurology
- Hematology
- Vascular Medicine
Background:
- Primary hematologic disorders are a known cause of ischemic stroke.
- Hemostatic parameter activation is frequently observed during acute stroke phases.
- It remains unclear if these abnormalities affect both cortical and lacunar infarcts.
Purpose of the Study:
- To investigate the presence of hematologic abnormalities and hemostatic derangements in patients with acute cerebral infarction.
- To determine if these abnormalities differ between cortical and lacunar infarcts.
Main Methods:
- Measured hematologic parameters including clotting and lysis times, and levels of fibrinogen, fibrinopeptide A, antithrombin III, protein C, protein S, and plasminogen.
- Analyzed data from 19 patients with acute cerebral infarction (10 cortical, 9 lacunar) within 48 hours of onset.
Main Results:
- Elevated fibrinopeptide A levels (indicating enhanced thrombin activity) were found in 12 patients (7 cortical, 5 lacunar).
- Impaired fibrinolysis was observed in 8 patients (6 lacunar, 2 cortical).
- Lupus anticoagulants, decreased antithrombin III, and low protein C levels were also noted in some patients across both groups.
Conclusions:
- Both primary hematologic disorders and secondary hemostatic derangements can occur in patients with cortical or lacunar infarction.
- These findings highlight the significant role of hemostatic factors in the pathogenesis of different stroke types.