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Minimal change disease (MCD) is the most common cause of nephrotic syndrome in children, although it is not uncommon among adults. Endothelial cell injury, platelet hyperreactivity and hyperaggregability secondary to increased activity of adenosine biphosphate lead to thrombosis. Microalbuminuria is an index of generalized vascular endothelial dysfunction, especially in hypertension and diabetes and a well-recognized risk factor for stroke in men and women, independent of other vascular risk factors and regardless of stroke mechanism. Hyperlipidemia may also contribute to the increased risk for thrombosis seen in nephrotic syndrome. Cerebral arterial infarction is an uncommon yet treatable cause of stroke in patients with nephrotic syndrome, predominantly in patients with membranous glomerulo nephropathy (MGN) followed by focal segmental glomerulosclerosis and immunoglobulin A (IgA) nephropathy, and rarely minimal change nephropathy. Magnetic resonance angiography and magnetic resonance venography are helpful to confirm the diagnosis, and dye contrast catheter cerebral angiography is rarely necessary.
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