What are the recommendations for testing for thrombophilic states in patients with stroke?
Testing for thrombophilic states such as prothrombin 20210A mutation, activated protein C resistance (factor V Leiden), deficiencies of protein C, protein S, or antithrombin, and elevated factor VIII levels should be considered in certain clinical scenarios (eg, paradoxical emboli caused by venous thrombosis or recurrent venous thrombosis) in patients with stroke. Testing for protein C, protein S, or antithrombin levels should be deferred or repeated at least 4 to 6 weeks (or up to 6 months for factor VIII) after the acute stroke given that these protein levels may be altered during the acute stroke phase.