The relationship between anemia and recurrence of ischemic stroke in patients with Trousseau's syndrome: A retrospective cross-sectional study

Usefulness of Mechanical Thrombectomy in Patients with Cancer Who Developed Cerebral Infarction

Mechanical thrombectomy (MT) is an established treatment for large vessel occlusion in the acute phase of stroke. However, its efficacy and safety in patients with cancer remain unclear. This study aimed to evaluate the therapeutic effect of MT against large vessel occlusion between patients with and without cancer. A total of 71 patients who underwent MT from August 2014 to November 2021 were included in this study. Patients with cancer and/or a history of cancer (n = 16) were included in the with cancer group and the remaining patients in the without cancer group (n = 55). The frequency of preoperative tissue plasminogen activator administration was significantly lower in the with cancer group (n = 2 [12.5%]) than in the without cancer group (n = 24 [43.6%]). However, there were no significant differences between the two groups in terms of treatment time, pass frequency, thrombolysis in cerebral infarction grade, modified Rankin scale score at 1 week after treatment [mRS (1w) ], modified Rankin scale score at discharge [mRS (ENT) ], modified Rankin scale score at 90 days after treatment [mRS (90 days) ], and length of hospital stay (days). In the multivariate analysis, if the objective variables were mRS (1w) and mRS (90 days), the National Institutes of Health Stroke Scale (NIHSS) and preonset mRS scores were considered significant variables. The presence or absence of cancer was not considered an independent factor of mRS (1w), mRS (ENT), or mRS (90 days). Aggressive treatment may be recommended to patients with cancer and/or a history of cancer who present with a systemic condition that can be managed with MT.

Clinical Features and Prognostic Factors of Acute Ischemic Stroke Related to Malignant Gastrointestinal Tumor

Objectives: To analyze the clinical and imaging features of acute ischemic stroke (AIS) related to gastrointestinal malignant tumor, and to explore the prognostic factors.

Methods: Clinical data of consecutive patients with gastrointestinal malignant tumor complicated with AIS admitted to the Department of Neurology and Oncology in Lanzhou University Second Hospital from April 2015 to April 2019 were retrospectively analyzed. Patients were divided into good prognosis (mRS 0–2) and poor prognosis (mRS > 2) based on a 90-day mRS score after discharge. The multivariate logistic regression model was used to analyze the prognostic factors.

Results: A total of 68 patients were enrolled with an average age of 61.78 ± 6.65 years, including 49 men (72.06%). There were 18 patients in the good prognosis group and 50 patients in the poor prognosis group. The univariate analysis showed that Hcy, D-dimer, thrombin–antithrombin complex (TAT), and three territory sign in magnetic resonance imaging (MRI) were the risk factors for poor prognosis. Multivariate analysis showed that increased D-dimer (OR 4.497, 95% CI 1.014–19.938) and TAT levels (OR 4.294, 95% CI 1.654–11.149) were independent risk factors for the prognosis in such patients.

Conclusion: Image of patients with gastrointestinal malignant tumor-related AIS is characterized by three territory sign (multiple lesions in different vascular supply areas). Increased TAT and D-dimer levels are independent prognostic risk factors. TAT is more sensitive to predict prognosis than D-dimer.

Clinical Features of Trousseau Syndrome With Cerebral Infarction as the Initial Manifestation

OBJECTIVE

There are few reports of Trousseau syndrome with cerebral infarction as the initial manifestation before the discovery of the tumor, which is often missed and misdiagnosed, and there is no unified therapy. To explore the clinical features of the Trousseau syndrome and, among those features, the risk factors for cerebral infarction as the initial manifestation.

METHODS

This was a retrospective study of 416 consecutive patients with cerebral infarction and malignant tumor admitted at The First Affiliated Hospital of Xinxiang Medical University between January 2015 and December 2017. The patients were grouped as: (1) cerebral infarction as the initial manifestation; and (2) tumor as the initial manifestation. A multivariable logistic regression analysis was used to analyze the relationship between the clinical features (age, sex, characteristics of the infarction, characteristics of the tumors, treatments, depression, coagulopathy, The National Institute of Health stroke scale score, platelet count, red cell count, hemoglobin, atherosclerosis, and coagulation parameters) and the hypercoagulable state.

RESULTS

A total of 416 patients met the criteria were included: 212 (51.0%) in the group with cerebral infarction as the initial manifestation and 204 (49.0%) in the group with tumor as the initial manifestation. The multivariable analysis showed that metastatic cancer (odds ratio=2.517; 95% confidence interval, 1.193-5.311; P=0.015) and depressive state (odds ratio=3.158; 95% confidence interval, 1.522-6.551; P=0.002) were independently associated with the Trousseau syndrome with cerebral infarction as the main manifestation.

CONCLUSIONS

Trousseau syndrome with cerebral infarction as the initial manifestation was associated with metastatic cancer and depressive state. There was no difference in coagulation status between the 2 groups.