Hypercoagulability State in Predicting Severe Functional Outcome in Patients with Acute Ischemic Stroke: Cause, Consequence, or Both?

Acute ischemic stroke might be associated with hypercoagulability in approximately 30 to 40% of these patients. This association could be explained by the fact that the exposure of collagen in damaged vessels triggers a cascade of coagulation factors which therein forms the emboli that can occlude cerebral arteries. Hypercoagulability could also be involved in early neurological deterioration which occurs in approximately 20 to 30% of patients following acute ischemic stroke. In fact, most patients with early neurological deterioration have a worse outcome due to either an infarct enlargement or early recurrence. In these cases, abnormal thrombotic pathways, especially increased coagulation activity, have been suggested to play a role in the pathophysiology of neurological deterioration.