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Hematologic disorders associated with ischemic stroke

T Tatlisumak1, M Fisher

  • 1Department of Neurology, Medical Center of Central Massachusetts-Memorial, Worcester, USA.

Journal of the Neurological Sciences
|September 1, 1996
PubMed
Summary
This summary is machine-generated.

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Hematological disorders are a rare cause of ischemic stroke. Careful evaluation, including coagulation studies in selected patients, is crucial for diagnosing these conditions and preventing recurrent events.

Area of Science:

  • Neurology
  • Hematology
  • Cardiovascular Medicine

Background:

  • Hematological disorders account for a small fraction of ischemic stroke cases.
  • The link between coagulation abnormalities and stroke etiology is not fully understood.
  • Current knowledge relies on limited case reports and small studies, primarily in younger patients.

Purpose of the Study:

  • To investigate the role of coagulation abnormalities in ischemic stroke.
  • To determine the utility of extensive hematologic evaluation in unselected stroke patients.
  • To propose a strategy for identifying stroke patients who may benefit from coagulation studies.

Main Methods:

  • Review of existing literature on hematological disorders and ischemic stroke.
  • Analysis of the diagnostic yield and cost-effectiveness of extensive hematologic testing.

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  • Development of a step-by-step approach for coagulation assessment in stroke patients.

    • Main Results:

    • Extensive hematologic evaluation in unselected stroke patients is often uninformative and costly.
    • Selected patients, including those with unexplained strokes, prior thrombosis, or family history, warrant further coagulation studies.
    • Hypercoagulable states increase the risk of recurrent arterial and venous thromboembolism, potentially benefiting from anticoagulation.

    Conclusions:

    • A targeted, step-by-step approach to coagulation assessment, starting with patient and family history, is recommended.
    • Coagulation testing should be reserved for selected stroke patients.
    • Early identification and management of hereditary coagulation disorders can benefit patients and their relatives.