Stroke Complicating Systemic Immune Mediated Disorders

Immune mediated systemic disorders may involve the cerebral blood vessels and cause brain ischemia or hemorrhage. Pertinent causes of stroke associated with immune disorders include cardioembolism due to direct involvement of the heart and its valves by the underlying disorder, vasculopathy and a hypercoagulable state related to the primary disorder, frank vasculitis of the cerebral blood vessels, and an increased rate of atherosclerotic changes in the cerebral vasculature secondary to other organ involvement by the primary disease process. It is extremely important to define the exact pathology involved as treatment options vary. Despite the fact that brain involvement is associated with unfavorable prognosis in many of these disorders, prevention of further cerebrovascular events is a feasible goal in most. Furthermore, specific therapy aimed at the cause of the disease (eg, immunosuppressive therapy in giant cell arteritis) results in greatly improved survival rates in certain disorders.