Abstract
A 65-year-old man had four ischemic strokes during a 6-month-period, two episodes occurred prior to admission and other two occurred while he was hospitalized. He was a heavy smoker and tested positive for anticardiolipin IgG antibody. Furthermore, he had renovascular hypertension, diabetes mellitus and low serum HDL-cholesterol. Multiple ischemic lesions were demonstrated in both cerebral hemispheres on MRI. Neurological symptoms were bilaterally observed in the sensory and motor system. His blood pressure and blood glucose level were controlled by antihypertensive drugs and diet, respectively, and he quited smoking. Although ticlopidin (100 mg/day) was orally administered, two atacks still developed after the admission. A combination therapy of warfarin potassium (2 mg/day) and aspirin (81 mg/day) was replaced for ticlopidine. Since then, he has been free from further attacks for 6 months. Anticardiolipin antibody and other multiple risk factors might have made the patient susceptible to the recurrent brain infarction. A prophylactic therapy of warfarin potassium and aspirin seems to be of use in these patients.
