What is the relationship between acquired hypercoagulable states and ischemic stroke?
The acquired and hereditary hypercoagulable states (thrombophilias) are associated with venous thrombosis, but a relationship with arterial cerebral infarction is based largely on case series or case-control studies. Of these, the presence of aPLs, generally an acquired condition, is most strongly associated with arterial thrombosis. Retrospective and prospective studies suggested an association between aCL and first ischemic stroke. Case-control studies of aPL in young stroke patients have uniformly demonstrated an association, as have most studies of unselected stroke populations. However, this is not the case for case-control studies among older adults with ischemic stroke. The Sneddon syndrome was formerly thought to be a manifestation of aPL syndrome, but it may be present in patients with or without aPLs, and the risk of ischemic stroke is increased only in those patients with increased aPLs. 