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We retrospectively and prospectively reviewed the incidence of stroke in 105 patients with systemic lupus erythematosus(SLE).Stroke occurred in 14 (15%)of 91 consecutive patients with documented SLE;nine(64%)of the 14 had multiple cerebral infarcts.Factors associated with stroke and the frequency of stroke were systemic thrombosis(30%),elevated partial thromboplastin time(36%),spontaneous abortion(50%),age over 60 years(57%), transient ischemic attacks(57%),previous stroke(64%),and cardiac valvular disease(86%).The major period of risk for the first stroke was during the first 5 years of SLE.The most frequent etiology was a cardiogenic embolus or an antibody-mediated hypercoagulable state,with cerebral vasculitis occurring only in association with infection.Because of the decreased fibrinolysis seen in patients with SLE,anticoagulant therapy may be the most effective preventive treatment currently available.Anticoagulant therapy seemed to prevent recurrent focal cerebral ischemia in our patients and was associated with relatively few and minor complications. Patients with a history of transient ischemic attacks or cardiac valvular lesions are at high(57%and 87%,respectively)risk of stroke.Patients who have had a stroke are at high(64%)risk for a recurrent stroke. Anticoagulant therapy is recommended for all of these patients. |
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abortion,spontaneous
anticoagulant,treatment
cerebral embolism
cerebral embolism,cardiac origin
cerebrovascular accident
cerebrovascular accident,incidence of
cerebrovascular accident,multiple
cerebrovascular accident,prevention of
cerebrovascular accident,recurrent
echocardiogram
embolism
endocarditis,Libman-Sacks
heart murmur
intracerebral hemorrhage
lupus anticoagulant
mitral valve vegetation
pulmonary embolism
systemic lupus erythematosus
systemic lupus erythematosus,neurologic complications with
transient ischemic attack
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