Abstract
The factor V Leiden mutation is a specific point mutation in the gene coding for factor V. It renders activated factor V resistant to degradation by activated protein C (APC). This hereditary resistance to APC (HRAPC) is a known risk factor for systemic venous thrombosis. We present a case of homozygous HRAPC presenting as cerebral venous thrombosis (CVT). A 24-year-old woman presented with a dense left hemiplegia and papiledema. A computed tomography scan showed a high ritht parieto-occipital infarct with hemorrhagic conversion. Angiography confirmed the diagnosis of extensive CVT. Treatment included heparin and direct intrathrombus thrombolysis initially as a bolus and then as an infusion for 21 hours. Repeat angiography showed partial recanalization. After 9 days, the patient was discharged on warfarin with minimal residual left weakness but persistent papilledema. Homozygous HRAPC appears to be a risk factor for CVT and should be considered in the evaluation of CVT.
Original language | English (US) |
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Pages (from-to) | 370-372 |
Number of pages | 3 |
Journal | Journal of Stroke and Cerebrovascular Diseases |
Volume | 6 |
Issue number | 5 |
DOIs | |
State | Published - Jul 1997 |
Keywords
- APC
- Cerebral venous thrombosis
- HRAPC
ASJC Scopus subject areas
- Surgery
- Rehabilitation
- Clinical Neurology
- Cardiology and Cardiovascular Medicine