Ischemic Stroke in Cancer Patients With and Without Conventional Mechanisms
- 1 April 2010
- journal article
- letter
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 41 (4), 798-801
- https://doi.org/10.1161/strokeaha.109.571356
Abstract
Background and Methods— To assess the precise mechanisms of stroke in cancer patients, we analyzed the data for cancer patients with acute ischemic stroke registered from 6 centers in South Korea. Clinical features, risk factors, diffusion-weighted imaging lesion patterns, and laboratory findings including d -dimer levels were compared between patients with conventional stroke mechanisms (CSMs) and cryptogenic group. Results— A total of 161 patients were included in this study: 97 (60.2%) patients in the CSM group and 64 (39.8%) in the cryptogenic group. Patients in the CSM group were older and vascular risk factors were more prevalent than in the cryptogenic group. Diffusion-weighted imaging patterns of multiple lesions involving multiple arterial territories were observed more frequently in the cryptogenic group than in the CSM group. In addition, levels of the d -dimer were higher in the cryptogenic group than in the CSM group (11.5±14.6 versus 3.6±10.3 μg/dL). In multivariate analysis, the diffusion-weighted imaging lesion pattern of multiple vascular territories (odds ratio, 11.2; 95% CI, 3.74 to 33.3), and d -dimer levels of >1.11 μg/dL (odds ratio, 10.6; 95% CI, 3.29 to 33.8) were associated independently with the cryptogenic group. Conclusions— Stroke outside of CSM occurred in a large number in cancer patients. In stroke patients with cancer, d -dimer levels and diffusion-weighted imaging lesion patterns may be helpful in early identification of non-CSMs (especially coagulopathy associated with cancer) and possibly in guiding preventive strategies for stroke.Keywords
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