CEREBROVASCULAR-DISEASE RISK-FACTORS - NEURORADIOLOGIC FINDINGS IN PATIENTS WITH ACTIVATED PROTEIN-C RESISTANCE

PURPOSE: To assess the patterns of abnormal neuroradiologic findings i n patients with a hypercoagulable state related to activated protein C (APC) resistance. MATERIALS AND METHODS: Records in 23 patients with a hypercoagulable state related to APC resistance (18 women, five men; average age, 44.5 years) were reviewed for cerebrovascular disease ri sk factors and other causes of a hypercoagulable state. Computed tomog raphic scans, magnetic resonance (MR) images, angiograms, and transeso phageal echocardiograms were also reviewed. RESULTS: Stroke risk facto rs or other causes of a hypercoagulable state were found in 12 patient s. Arterial infarcts were seen in:18 patients; Hyperintense white matt er foci were seen on MR images in six patients. Dural sinus thrombosis was found in four patients. Angiograms of intracranial circulation in six patients showed major artery occlusions in four. MR angiograms in four patients showed internal carotid artery occlusion in one. No maj or abnormalities were seen in extracranial cerebral vasculature in 15 patients. Transesophageal echocardiograms in 11 patients showed a pate nt foramen ovale in one patient but no systemic source of embolism. Se ven patients had non-central nervous system thrombotic events. CONCLUS ION: patients with APC resistance and stroke appear to differ from the general stroke population in terms of age and frequency of extracrani al sources of cerebrovascular disease.