Stroke as the first manifestation of concealed cancer
Stroke as the first manifestation of concealed cancer
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DOI：
10.1016/j.jns.2007.02.035
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发表时间：
2007-07-15
影响因子：
4.4
通讯作者：
Yoon, Byung-Woo
中科院分区：
文献类型：
--
作者：
Kwon, Hyung-Min;Kang, Bong Su;Yoon, Byung-Woo
背景和目的：特鲁索综合征（TS）被定义为发生于患有潜在或未确诊恶性肿瘤的患者中的与恶性肿瘤相关的血栓栓塞。中风很少作为癌症的首发表现出现。我们调查了 TS 患者的临床和放射学特征。方法：我们回顾了连续卒中患者的临床、病理和放射学记录，这些患者的癌症在卒中就诊时被诊断出来。如果没有确定明确的原因，并且在首次中风发作后 6 个月内检测到恶性肿瘤且未进行癌症相关治疗，则定义为癌症相关中风。所有患者均接受脑弥散加权 MRI (DWI)、MR 血管造影和超声心动图检查。记录 DWI 中所有高信号病灶的大小、数量和位置。结果：最终分析了 10 名患者。组织学上，癌症经常被证明为晚期腺癌（50%，5/10）。接受测试的 10 名患者中有 6 名 (60%) D-二聚体升高。 10 名患者中的 7 名 (70%) 显示双半球前部和后部受累。 DWI 特征显示 9 名患者 (90%) 的多个区域存在大量小、中或大病变。 结论：作者强调，当 DWI 上出现多发性双半球梗死且病因不明时，神经科医生必须考虑隐藏的癌症的存在。 (c) 2007 Elsevier B.V. 保留所有权利。
Background and purpose: Trousseau's syndrome (TS) is defined as a malignancy-related thromboembolism occurring in patients with an underlying or undiagnosed malignancy. Stroke seldom occurs as the first manifestation of a cancer. We investigated the clinical and radiological features of patients with TS.Methods: We reviewed the clinical, pathologic, and radiological records of consecutive stroke patients, whose cancers were diagnosed at stroke presentation. Cancer-related stroke was defined if no definite cause was confirmed and malignancy was detected within 6 months of first stroke onset without cancer-related treatment. All patients underwent brain diffusion-weighted MRI (DWI), MR angiography, and echocardiography. The sizes, numbers, and locations of all hyperintense lesions in the DWI were noted.Results: Ten patients were finally analyzed. Histologically, cancers were often proven to adenocarcinomas (50%, 5/10) of advanced stage. Six of 10 patients tested (60%) had elevated D-dimer. Seven of the 10 patients (70%) showed bihemispheric anterior and posterior involvement. DWI features showed numerous small and medium or large lesions in multiple territories in 9 patients (90%).Conclusions: The authors emphasize that when presented with multiple bihemispheric infarctions on DWI and an unknown etiology, the neurologist must consider the existence of a concealed cancer. (c) 2007 Elsevier B.V. All rights reserved.