Clinical analysis of twenty-one cases of acute ischemic stroke related to Trousseau syndrome,Neurological Sciences

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Clinical analysis of twenty-one cases of acute ischemic stroke related to Trousseau syndrome
Neurological Sciences ( IF 2.7 ) Pub Date : 2023-11-13 , DOI: 10.1007/s10072-023-07180-2
Bingqing Zhao ₁ , Weihua Jia ₁ , Ye Yuan ₁ , Zheng Li ₁

Affiliation

Background

Trousseau syndrome (TS) is relatively rare and easily overlooked by clinicians, causing misdiagnosis and affecting subsequent treatment.

Objective

In this study, clinical features, laboratory examination, imaging features, treatment, and prognosis of patients with TS were discussed.

Methods and material

From February 2018 to April 2022, cases of 21 patients with malignant tumors complicated by acute ischemic stroke (AIS) were admitted to the Neurology Department of the hospital, and were retrospectively analyzed and discussed based on the literature.

Results

Twenty-one cases were included in the study. Of these, 95.23% (20/21) developed AIS 6–21 months after the onset of malignant tumors, 9.52% (2/21) had ischemic stroke as the first symptom, 4.76% (1/21) had recurrent ischemic stroke, and 14.29% (3/21) subsequently experienced venous and arterial thrombosis events; 80.95% (17/21) were pathologically confirmed to have adenocarcinoma; and 90.47% (19/21) of infarction cases involved multiple blood vessel feeding sites. MRI showed multiregional, multifocal patchy infarcts. d-dimer concentration was higher than normal in all patients. In addition, 61.90% (13/21) of the patients had poor outcomes according to mRS.

Conclusion

TS is a rare clinical type. It is often associated with adenocarcinoma, and the treatment is different from that of conventional cerebral infarction and the prognosis is very poor. In clinical practice, for AIS of unknown cause, if MRI shows multiple small lesions accompanied by a significant increase in d-dimer, routine screening for latent malignant tumors is recommended.

中文翻译：

Trousseau综合征相关急性缺血性脑卒中21例临床分析

背景

Trousseau综合征（TS）相对罕见，很容易被临床医生忽视，造成误诊并影响后续治疗。

客观的

本研究对 TS 患者的临床特征、实验室检查、影像学特征、治疗和预后进行了讨论。

方法和材料

2018年2月至2022年4月，该院神经内科收治21例恶性肿瘤并发急性缺血性脑卒中（AIS）患者的病例，根据文献进行回顾性分析和讨论。

结果

该研究纳入了二十一个病例。其中，95.23%（20/21）在恶性肿瘤发病后6-21个月出现AIS，9.52%（2/21）以缺血性脑卒中为首发症状，4.76%（1/21）有复发性缺血性脑卒中， 14.29%（3/21）随后经历了静脉和动脉血栓形成事件； 80.95%（17/21）病理证实为腺癌； 90.47%（19/21）的梗死病例涉及多个血管供血部位。 MRI 显示多区域、多灶性斑片状梗塞。所有患者的d-二聚体浓度均高于正常值。此外，根据 mRS，61.90% (13/21) 的患者预后较差。