{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T15:22:56Z","timestamp":1789226576225,"version":"build-2803163510"},"reference-count":52,"publisher":"Georg Thieme Verlag KG","issue":"12","license":[{"start":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T00:00:00Z","timestamp":1733788800000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq Neuropsiquiatr"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by thrombosis, pregnancy complications, and other nonthrombotic manifestations in the presence of antiphospholipid antibodies. Neurovascular complications, including ischemic stroke, cerebral venous thrombosis and cognitive impairment, pose significant challenges in management.<\/jats:p><jats:p>\n          Objective\u2003To comprehensively review relevant and updated clinical aspects of neurovascular manifestations of APS.<\/jats:p><jats:p>\n          Methods\u2003We conducted a narrative review using the PubMed, EMBASE, and Cochrane Library databases with medical terms related to APS and its neurovascular manifestations. English-language studies, published between January 1, 2015, and March 2024, were included. Key publications outside this timeframe were also considered. Studies with higher levels of evidence, such as randomized controlled trials and meta-analyses, were prioritized for inclusion.<\/jats:p><jats:p>\n          Results\u2003Stroke is a prevalent complication in APS, with arterial thrombosis being a predominant mechanism. Despite recent trials, direct oral anticoagulants (DOACs) have not shown superiority over vitamin K antagonists (VKAs) for secondary prevention in this population. Cerebral venous thrombosis (CVT), although rare, can also occur in APS, and while DOACs have shown promise as a treatment in a general population, caution is warranted due to potential harm. Cognitive impairment affects a considerable proportion of APS patients, with thrombotic and nonthrombotic mechanisms contributing to its pathophysiology. Future research should focus on optimal management strategies for cognitive impairment and the efficacy of anticoagulation and immunosuppression.<\/jats:p><jats:p>\n          Conclusion\u2003Understanding the complex interplay of neurovascular manifestations in APS is essential for guiding clinical decisions and improving patient outcomes. Despite advancements, some challenges remain in establishing effective preventive and treatment measures, highlighting the need for further research in this field.<\/jats:p>","DOI":"10.1055\/s-0044-1793932","type":"journal-article","created":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T01:08:53Z","timestamp":1733879333000},"page":"001-007","source":"Crossref","is-referenced-by-count":3,"title":["Neurovascular complications of antiphospholipid syndrome: a narrative review"],"prefix":"10.1055","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7084-5784","authenticated-orcid":false,"given":"George Nilton Nunes","family":"Mendes","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Montr\u00e9al, Centre Hospitalier, Programme de Sant\u00e9 Neurovasculaire, Montr\u00e9al Qu\u00e9bec, Canada."},{"name":"Universit\u00e9 de Montr\u00e9al, Centre Hospitalier, Centre de Recherche, Axe Neurosciences, Montr\u00e9al Qu\u00e9bec, 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