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47 - HYPERVISCOSITY AND STROKE

from PART V: - SYSTEMIC DISORDERS THAT ALSO INVOLVE THE CEREBROVASCULAR SYSTEM

Published online by Cambridge University Press:  06 January 2010

By
John F. Dashe
Edited by
Louis R. Caplan  and
Julien Bogousslavsky
Louis R. Caplan
Affiliation:
Beth Israel Deaconess Medical Center, Boston
Julien Bogousslavsky
Affiliation:
Valmont Clinique, Glion, Switzerland
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Summary

The association of elevated hematocrit and fibrinogen levels with increased stroke risk has led to continued interest in hemorheologic factors and their role in the development of vascular disease and acute stroke. Viscosity increases logarithmically at the lowest shear rates and this effect is magnified at higher hematocrit levels. Fibrinogen may play a causal role in ischemic stroke through several mechanisms. The most prominent of these is its essential role in thrombosis, both as the substrate for fibrin clot formation and as a facilitator of platelet aggregation. The risk of stroke in sickle cell disease (SCD) varies according to genotype and is highest in patients with homozygous SS. Plasma hyperviscosity syndromes are treated by plasmapheresis (plasma exchange) to remove the paraproteins and thereby reduce hyperviscosity and hypervolemia. Newer techniques of cell centrifugation, plasma separation, and filtration may also be useful.

Keywords

anti-phospholipid antibodiesantiaggregant therapyanticoagulant therapycerebral angiographyimmunoreactivity assaysechocardiographyischemic strokecerebrovascular diseaseSneddon's syndrome
Type
Chapter
Information
Uncommon Causes of Stroke , pp. 347 - 356
Publisher: Cambridge University Press
Print publication year: 2008

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