Oral clopidogrel load in aspirin-resistant capsular warning syndrome.

INTRODUCTION

Capsular warning syndrome (CWS) carries a significant risk of permanent stroke. There are no proven therapies for preventing completed stroke in this unstable situation.

METHODS

Clinical observation in two patients with aspirin-resistant CWS treated with a loading dose of oral clopidogrel.

RESULTS

Both patients had excellent neurological outcome, although one sustained an asymptomatic brain infarction.

CONCLUSION

High-dose oral clopidogrel plus aspirin merits formal evaluation in high-risk transient brain ischemia such as CWS, preferably in a randomized trial compared to aspirin alone.