+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Coagulation abnormalities in lacunar and cortical ischemic stroke are quite different

Coagulation abnormalities in lacunar and cortical ischemic stroke are quite different

Neurological Research 20(1): 15-18

In order to clarify the coagulation profile accompanying ischemic stroke, which may have implications on therapeutic strategies, we performed a prospective study to evaluate the hemostatic parameters in the first 24 h after the onset of cortical atherothrombotic infarct and lacunar infarction. Twenty-seven patients with cortical atherothrombotic infarction and 27 patients with lacunar infarction, diagnosed on clinical and CT-scan criteria, had blood samples taken within the first 24 h after onset of the stroke, and before anticoagulant treatment had been started. Levels of fibrinogen, von Willebrand factor, D-dimers, prothrombin factors 1 + 2, anti-thrombin III, and C-protein and S-proteins, were measured. Laboratory tests detected the following abnormalities: a protein C deficiency was observed in 1 case of cortical infarction and in 1 case of lacunar infarction; a decrease in S-protein was observed in 1 case of cortical infarction, and the presence of lupus anticoagulant in 4 cases (2 in cortical and 2 in lacunar infarction). Various degrees of coagulation activation were observed. Statistically significant activation of the coagulation was observed in the patients with cortical infarction, compared to normal patients adjusted for age: the levels of DDI were significantly raised (2298 +/- 2221 ng ml-1 vs. 750 +/- 400 ng ml-1) (p < 0.03) as were F1 + 2 levels (3.9 +/- 2.8 nmol l-1 vs. 1.5 +/- 0.9 nmol l-1). (p < 0.01). In the lacunar infarction group, there was a significant rise in F1 + 2 compared with normal patients adjusted for age (2.2 +/- 1.7 nmol l-1 vs. 1.5 +/- 0.9 nmol l-1) (p < 0.01), while the DDI level was in the normal range, when age was taken into account. In the cortical infarction group, we observed a significantly raised fibrinogen level (4.8 +/- 1.7 g l-1 vs. 3.7 +/- 1.0 g l-1) (p < 0.05) and von Willebrand factor level (271 +/- 104% vs. 178 +/- 103%) (p < 0.01) compared to the lacunar infarction group. In addition, we observed a significantly low level of S-protein in the cortical infarction group (105 +/- 29%) compared to the lacunar infarction group (127 +/- 28%) (p < 0.01). Confirmation of the role of enhanced thrombin activity in the pathogenesis of acute stroke may be an important determinant in its therapeutic management.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 008338031

Download citation: RISBibTeXText

PMID: 9471097

DOI: 10.1080/01616412.1998.11740478

Related references

Blood markers of coagulation, fibrinolysis, endothelial dysfunction and inflammation in lacunar stroke versus non-lacunar stroke and non-stroke: systematic review and meta-analysis. Cerebrovascular Diseases 37(1): 64-75, 2014

Coated-platelets in ischemic stroke: differences between lacunar and cortical stroke. Journal of Thrombosis and Haemostasis 6(4): 609-614, 2008

Distinct non-cerebrovascular risk factors for ischemic lacunar stroke and non-lacunar stroke: preliminary results. Genetics and Molecular Research 14(2): 3170-3176, 2016

Segmental left ventricular wall motion abnormalities are associated with lacunar ischemic stroke. Clinical Neurology and Neurosurgery 108(8): 744-749, 2006

The electroencephalogram and acute ischemic stroke. Distinguishing cortical from lacunar infarction. Archives of Neurology 45(5): 520-524, 1988

Changes in background blood-brain barrier integrity between lacunar and cortical ischemic stroke subtypes. Stroke 39(4): 1327-1332, 2008

Immunoinflammatory activation during the acute phase of lacunar and non-lacunar ischemic stroke: association with time of onset and diabetic state. International Journal of Immunopathology and Pharmacology 19(3): 639-646, 2006

Differences between ischemic stroke subtypes in vascular outcomes support a distinct lacunar ischemic stroke arteriopathy: a prospective, hospital-based study. Stroke 40(12): 3679-3684, 2010

Coagulation abnormalities affecting young patients with an ischemic stroke. Neurology 56(8 Supplement 3): A163, April 24, 2001

Ischemic Stroke Incidence in Patients With Microvascular Ocular Motor Palsy Versus Patients With Lacunar Ischemic Stroke. Neurologist 24(2): 50-52, 2019

Factors associated with severity of leukoaraiosis in first-ever lacunar stroke and atherosclerotic ischemic stroke patients. Journal of Stroke and Cerebrovascular Diseases 23(10): 2862-2868, 2015

The -174G/C polymorphism of the interleukin 6 gene is a hallmark of lacunar stroke and not other ischemic stroke phenotypes. Cerebrovascular Diseases 19(2): 91-95, 2004

Differing risk factors and outcomes in ischemic stroke subtypes: focus on lacunar stroke. Future Neurology 6(2): 201-221, 2011

Effect of antiplatelet therapy on recurrent ischemic stroke and brain hemorrhage in lacunar stroke. Stroke 25(1): 272, 1994

17q25 Locus is associated with white matter hyperintensity volume in ischemic stroke, but not with lacunar stroke status. Stroke 44(6): 1609-1615, 2013