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Neurology (Expert Forum)
What is the cause?
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.
What is the cause?
by mwashen, May 19, 2002 12:00AM
I had a stroke 7 months ago and the doctors have no clue as to why? I am a 30 year old female, non smoker. I was taking oral contraceptives for about 6 to 7 years. The blood specialist I seen said it was not a factor; I would have had complications earlier. My diagnosis at the time of the stroke was superior sagittal venous thrombosis and was life threatening. They didn't think I was going to make it. It all started with a headache at work, my head was reeling and throwing up. I went to the ER and they did a CT, told me it was a migraine and to go home. I suffered the whole week. By Saturday, I was paralyzed on the left side and was rushed back to the hospital. They read the CT wrong. I had tPA and have recovered the use of my left side. However, I continue to have numbness and my head physically hurts all the time. My neuro has no clue why my head still hurts. I have been doing some research and people are telling me to get checked for APS. Could this be my problem? I have had some blood tests but it looks like they missed some. This is what I have been tested for: antithrombin III was 111%, protein C 47%, protein S 135%, Factor X 96%, Factor VII 21%,no lupus antocoagulant, no prothrombin G20210A detected, IgG cardiolipin antibody was 6, IgM was 2, homocysteine was 10.9 umol/l. Protein c low because of Coumadin use. What did they miss? Should I be checked for Factor V and IgA cardiolipin? Any ideas? Thank you as I need answers to why this has happened to me.
Doctor's Answer
by CCF-Neuro-M.D.-JT, May 20, 2002 12:00AM
Sorry to hear about your recent stroke. Sounds like you've had a thorough workup for a clotting disorder, including APS (this is the lupus anticoagulant and anticardiolipin antibody test as well as a PTT and platelet count which I'm sure was already done). We have seen a number of young women such as yourself who had a venous thrombosis while on oral contraceptives, which we feel is a risk factor in itself. Estrogen is thought to play a significant role in making the patient more liable to clotting disorders. Some women smoked which in combo with the OCP leads to increased risk of stroke,and some were dieting which led to dehydration and again an increased susceptibility to stroke. This is also seen in women who are pregnant or in the postpartum period due to a number of factors including the increased hormones. Also, keep in mind that 30% of strokes have no known cause.
As for the headaches, I have seen a significant number of young patients with stroke who complained of the same thing that you do. This has been written up in the medical literature, but no one is sure as to the exact mechanism of headache after stroke. Neurontin as well as elavil and other neuro-pain meds have been helpful in many patients. Talk to your neurologist about giving these meds a try. A followup scan may also be neededjust to make sure nothing else is going on in the brain.
Finally, Consider seeing a stroke neurologist for a complete evaluation. There should be one at a major academic or clinical center nearby. Good luck.
As for the headaches, I have seen a significant number of young patients with stroke who complained of the same thing that you do. This has been written up in the medical literature, but no one is sure as to the exact mechanism of headache after stroke. Neurontin as well as elavil and other neuro-pain meds have been helpful in many patients. Talk to your neurologist about giving these meds a try. A followup scan may also be neededjust to make sure nothing else is going on in the brain.
Finally, Consider seeing a stroke neurologist for a complete evaluation. There should be one at a major academic or clinical center nearby. Good luck.
