Abstract
Purpose: To evaluate cerebral arterial flow patterns in patients with anticardiolipin antibodies (ACL-Ab).Methods: Flow patterns in ACL-Ab positive patients with (n=15) and without (n=13) stroke or transient ischaemic attacks (TIA) were evaluated with transcranial Doppler (TCD). Flow was categorized as normal, focal stenosis, collateral or occlusive. A side to side, (left to right) difference (STSD) in mean flow velocity in any artery exceeding 30% was considered abnormal (aSTSD). The results were compared to those of a control group (n=30) which included age-matched patients with stroke but no ACL-Ab and a second control group (n=30) that included normal healthy adults.Results: Flow patterns were similar in ACL-Ab positive patients with and without clinical evidence for cerebral ischaemia, and aSTSD was the main abnormality identified. This pattern was significantly more common in ACL-Ab positive patients when compared to ACL-Ab negative patients and normal controls. TCD demonstrated an aSTSD in the presence of a normal MRI in two ACL-Ab positive patients with TIA, and in four ACL-Ab positive patients without clinical evidence for cerebral ischaemia.Conclusions: Abnormally increased STSD is commonly found in ACL-Ab positive patients and may precede the occurrence of overt ischaemic events. The significance of such STSD in these patients remains to be clarified.
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