Cargando…

Multifocal cerebral infarction as the first manifestation of occult malignancy: Case series of trousseau's syndrome and literature review

Ischemic stroke as an initial presentation of malignancy is extremely rare and the underlying etiology is often ignored. The aim of this study is to outline the clues to occult malignancy in patients presenting with cerebral infarction initially. The clinical characteristics of total 19 patients wit...

Descripción completa

Detalles Bibliográficos
Autores principales: Chen, Weibi, He, Yanbo, Su, Yingying
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6126242/
https://www.ncbi.nlm.nih.gov/pubmed/30276339
http://dx.doi.org/10.4103/bc.bc_1_18
_version_ 1783353302666182656
author Chen, Weibi
He, Yanbo
Su, Yingying
author_facet Chen, Weibi
He, Yanbo
Su, Yingying
author_sort Chen, Weibi
collection PubMed
description Ischemic stroke as an initial presentation of malignancy is extremely rare and the underlying etiology is often ignored. The aim of this study is to outline the clues to occult malignancy in patients presenting with cerebral infarction initially. The clinical characteristics of total 19 patients with Trousseau's Syndrome presenting with cerebral infarction initially were analyzed. Among those patients, no conventional vascular risk factors were detected in 68% (13/19) of patients, and infarction occurring in multiple vascular distributions was found in 84% (16/19). Blood test showed thrombophilia in 79% (15/19) of patients with significantly elevated D-dimer, disseminated intravascular coagulopathy (DIC) in 59% (11/19), and elevated levels of tumor makers in 47% (9/19). The prognosis of the 19 patients was poor, with 68% (13/19) of patients undergoing a relapse of stroke in short interval, and 84% (16/19) being reportedly to die in 6 months. In patients, who developed unexplained recurrent brain infarction involving multiple arterial territory, with laboratory evidence suggesting hypercoagulability (higher level of D-dimer, or DIC), Trousseau's Syndrome should be considered, and investigation for an occult malignancy was required.
format Online
Article
Text
id pubmed-6126242
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Medknow Publications & Media Pvt Ltd
record_format MEDLINE/PubMed
spelling pubmed-61262422018-10-01 Multifocal cerebral infarction as the first manifestation of occult malignancy: Case series of trousseau's syndrome and literature review Chen, Weibi He, Yanbo Su, Yingying Brain Circ Case Series Ischemic stroke as an initial presentation of malignancy is extremely rare and the underlying etiology is often ignored. The aim of this study is to outline the clues to occult malignancy in patients presenting with cerebral infarction initially. The clinical characteristics of total 19 patients with Trousseau's Syndrome presenting with cerebral infarction initially were analyzed. Among those patients, no conventional vascular risk factors were detected in 68% (13/19) of patients, and infarction occurring in multiple vascular distributions was found in 84% (16/19). Blood test showed thrombophilia in 79% (15/19) of patients with significantly elevated D-dimer, disseminated intravascular coagulopathy (DIC) in 59% (11/19), and elevated levels of tumor makers in 47% (9/19). The prognosis of the 19 patients was poor, with 68% (13/19) of patients undergoing a relapse of stroke in short interval, and 84% (16/19) being reportedly to die in 6 months. In patients, who developed unexplained recurrent brain infarction involving multiple arterial territory, with laboratory evidence suggesting hypercoagulability (higher level of D-dimer, or DIC), Trousseau's Syndrome should be considered, and investigation for an occult malignancy was required. Medknow Publications & Media Pvt Ltd 2018 2018-06-29 /pmc/articles/PMC6126242/ /pubmed/30276339 http://dx.doi.org/10.4103/bc.bc_1_18 Text en Copyright: © 2018 Brain Circulation http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Case Series
Chen, Weibi
He, Yanbo
Su, Yingying
Multifocal cerebral infarction as the first manifestation of occult malignancy: Case series of trousseau's syndrome and literature review
title Multifocal cerebral infarction as the first manifestation of occult malignancy: Case series of trousseau's syndrome and literature review
title_full Multifocal cerebral infarction as the first manifestation of occult malignancy: Case series of trousseau's syndrome and literature review
title_fullStr Multifocal cerebral infarction as the first manifestation of occult malignancy: Case series of trousseau's syndrome and literature review
title_full_unstemmed Multifocal cerebral infarction as the first manifestation of occult malignancy: Case series of trousseau's syndrome and literature review
title_short Multifocal cerebral infarction as the first manifestation of occult malignancy: Case series of trousseau's syndrome and literature review
title_sort multifocal cerebral infarction as the first manifestation of occult malignancy: case series of trousseau's syndrome and literature review
topic Case Series
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6126242/
https://www.ncbi.nlm.nih.gov/pubmed/30276339
http://dx.doi.org/10.4103/bc.bc_1_18
work_keys_str_mv AT chenweibi multifocalcerebralinfarctionasthefirstmanifestationofoccultmalignancycaseseriesoftrousseaussyndromeandliteraturereview
AT heyanbo multifocalcerebralinfarctionasthefirstmanifestationofoccultmalignancycaseseriesoftrousseaussyndromeandliteraturereview
AT suyingying multifocalcerebralinfarctionasthefirstmanifestationofoccultmalignancycaseseriesoftrousseaussyndromeandliteraturereview