In their review of patent foramen ovale in cryptogenic stroke, Wu et al1 include factor V Leiden, prothrombin 20210 mutation, proteins C and S deficiency, and antithrombin III deficiency among the thrombophilic abnormalities causing and predisposing to stroke and transient ischemic attack and recommend screening younger individuals presenting with stroke.
In contrast to the association between antiphospholipid antibodies and lupus anticoagulants and arterial thrombosis, these inherited thrombophilic abnormalities have been shown not to be significantly linked with stroke or transient ischemic attack.2 The high prevalence of these abnormalities makes the probability of a coincidental finding high. Although factor V Leiden and prothrombin 20210 mutation may play a small role in a subtype of stroke,3 their inclusion in the routine investigation of ischemic stroke is not recommended by current guidelines.4
Butler A, Neilson R. Thrombophilia Screening and Ischemic Stroke. Arch Intern Med. 2004;164(22):2500-2509. doi:10.1001/archinte.164.22.2502-a