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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...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2018
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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 |
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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 |
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