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Inherited protein C deficiency and nonhemorrhagic arterial stroke in young adults

Divisione di Neurologia 2a (Drs. Camerlingo, Casto, Laffranchi, and Mamoli) and the Divisione di Ematologia (Drs. Finazzi and Barbui), Ospedali Riuniti, Bergamo, Italy.

Out of a consecutive series of 50 young people less than 45 years old with nonhemorrhagic arterial stroke, three patients had inherited protein C deficiency. CT revealed hypodense areas consistent with the clinical picture, and angiography showed occlusion of some intracranial arterial vessels. Other possible associated causes of stroke were ruled out. One patient had a transient ischemic attack and a peripheral venous thrombosis prior to the actual stroke, whereas the others were completely asymptomatic, as were relatives with the same deficiency. We suggest determining protein C in ischemic stroke of all young adults, especially when major risk factors are excluded.

Address correspondence and reprint requests to Dr. Massimo Camerlingo, 2a Divisione di Neurologia, Ospedali Riuniti, Largo Barozzi, 1, 24100 Bergamo, Italy.

Received July 26, 1990. Accepted for publication in final form February 7, 1991.

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