Lupus anticoagulant (LA) and anticardiolipin antibody (aCL) are circulating immunoglobulins against phospholipids which can result in prothrombotic conditions. We present our experience of 45 LA nd/or aCL positive stroke patients. LA was tested
with a
cobmbination of aPTT mixing test, thromboplastin inhibition test, and kaolin clotting time. ACL was measured with ELIZA. There were 33 males and 12 females with their ages ranging from 20 to 76 (mean 51.8). Fifteen patients did not have risk
factors for
stroke, while 13 had a single, and 17 had multiple risk factors. Hypertension (20 cases ) and smoking (14 cases) were the important risk factors while cardiacdiseases were found in 9 patients. All patients underwent head CT and/or MRI, which
showed
multiple infarcts in 18, single infarct in 22, intracerebral hemorrhages. In 4, cortical venous infarct in 1 and sagittal sinus thrombosis in 1. Among patients with cerebral infarct, 23 had infarcts in carotid territory, only 7 of whom had large
infarcts involving the cerebral cortex. Eleven had strokes in vertebro-basilar territory, an 6 had in both. Overall, 22 patients had relatively small infarcts in carotid territory. Angiogram was performed in 23 patients, which showed normal
findings in
14 (most did not have risk factors), internal carotid narrowing or occlusion in 2, proximal MCA narrowing in 2, occlusion of vertebral artery in 1, multiple MCA and ACA occlusion in 1, and venous occlusion in 1 Interestingly, one patient showed
occlusion of proximal branches of aorta consistent with Takayasu's disease. We conclude that relatively small multiple or single ischemic infarcts with negative angiographic findings are the most characteristic findings of antiphospholipid
antibody
associated stroke, while occasionally observed marked angiographic abnor malities or large cerebral embolic strokes are usually associated with other risk factors. Antiphospholipid antibodies. Seem to play a role in the development of
cerebrovascular
diseases in korean patients especially in the young aged group.
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