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Stroke, Vol 22, 90-93, Copyright © 1991 by American Heart Association

ARTICLES

Cerebral infarction in patients with nephrotic syndrome

EE Marsh 3d, J Biller, HP Adams Jr and JM Kaplan
Department of Neurology, University of Iowa College of Medicine, Iowa City.

We describe two adult patients who presented with acute cerebral infarction and were found to have a hypercoagulable state due to nephrotic syndrome. One patient had a deficiency of free protein-S. The other patient had a pulmonary embolus 4 months after the stroke. Our cases demonstrate that the hypercoagulable state associated with nephrotic syndrome can be associated with cerebral arterial thrombosis and infarction in adults. Examination of the urine remains an important part of the evaluation of patients with recent stroke. The presence of severe proteinuria and a low serum albumin content should prompt consideration of a hypercoagulable state. Our experience suggests that anticoagulant drugs may be required to reduce the risk of new thrombotic events.