Prothrombotic states and cerebral ischemia
Introduction. Hematological disorders per se represent unusual causes of cerebral ischemia, explaining in young people 4% of strokes. Hematological disorders that induce a thrombotic tendency contribute to overall ischemic stroke risk and may directly cause cerebral ischemia in patients without other risk factors. The frequency of cerebral infarctions caused by prothrombotic states is not known. Development. This review will focus on disorders such as prothrombotic coagulopaties, including resistance to activated protein C and antiphospholipid syndrome as cause of cerebral infarction. Cerebral venous thrombosis and cerebral infarction from arterial origin are the most common form of neurological involvement. Pathophysiological mechanism of stroke in these patients are multiple and can include as in antiphospholipid syndrome embolism from valves abnormalities related to hematological disturbance, as well as thrombosis of extracranial or intracranial vessels. Conclusions. Is clear, however, that prothrombotic states could explains a high percentage of cases of those so called cryptogenic cerebral infarction in young people
Desarrollo Esta revisión se dirigirá específicamente a aquellas alteraciones hematológicas que producen un estado protrombótico, incluyendo anormalidades recientemente descritas como la resistencia a la proteína C activada y síndrome antifosfolípido como causa de infarto cerebral. La trombosis venosa cerebral y el infarto cerebral de tipo arterial son las principales manifestaciones neurológicas de estos estados protrombóticos. La fisiopatología de la isquemia cerebral asociada a estas anormalidades hematológicas es diversa e incluye el embolismo asociado a alteraciones valvulares cardíacas, como en el síndrome antifosfolípido, así como trombosis de vasos extra o intracraneales.
Conclusiones Los estados protrombóticos explican indudablemente un alto porcentaje de casos de infarto cerebral hasta entonces considerado criptogénico
