ANTIPHOSPHOLIPID ANTIBODIES IN PATIENTS WITHOUT SYSTEMIC LUPUS-ERYTHEMATOSUS - NEURORADIOLOGIC FINDINGS

PURPOSE: To study neuroradiologic findings in patients with hypercoagu lability due to antiphospholipid antibodies (APAs). MATERIALS AND METH ODS: Retrospective review of abnormal angiographic, computed tomograph ic, and magnetic resonance imaging findings was performed over a 14-mo nth period in patients with APAs, no diagnosis of systemic lupus eryth ematosus, age less than 65 years, and no other cause of a hypercoaguab le state. RESULTS: Fourteen patients (age range, 22-62 years) with APA s had abnormal results at neuroradiologic examination. Abnormal findin gs on cross-sectional imaging studies included large-artery (n = 3), l acunar (n = 5), and venous infarctions (n = 2); cortical atrophy (n = 5); white matter abnormalities (n = 3); and dural sinus thrombosis (n = 4). Abnormal angiographic findings included large-artery occlusions (n = 2), arterial narrowing that simulated vasculitis (n = 2), and tra nsverse sinus thrombosis (n = 1). CONCLUSION: Presence of APAs should be suspected when no cause is apparent for either (a) an ischemic cere brovascular event in young and middle-aged adults or (b) dural sinus o r cerebral venous thrombosis (c) in patients with recurrent systemic a rterial or venous thromboses, especially women with recurrent miscarri ages.