Kondziolka D, Bernstein M, Resch L, Tator C H
Can Fam Physician. 1988 Feb;34:283-6.
A review of 905 consecutive cases of pathologically confirmed brain tumour yielded 25 cases in which the initial presentation strongly suggested the diagnosis of occlusive cerebrovascular disease. Most of these 25 patients were admitted through the emergency department of our hospital and referred to the general medical service for investigation. Nineteen cases of transient ischemic attack and six cases of completed stroke were found in 12 cases of glioblastoma, seven of meningioma, two of metastatic renal cell carcinoma, and one case each of malignant astrocytoma, low-grade astrocytoma, oligodendroglioma, and metastatic squamous cell carcinoma. We document the clinical overlap between neoplastic and vascular syndromes, and stress the need for "tumour awareness" in the work-up of patients presenting to non-neurological practitioners with the clinical picture of occlusive cerebrovascular disease.
对905例经病理确诊的脑肿瘤连续病例进行回顾分析,发现其中25例患者最初的临床表现强烈提示为闭塞性脑血管疾病。这25例患者中的大多数通过我院急诊科入院,并被转至普通内科进行检查。在12例胶质母细胞瘤、7例脑膜瘤、2例转移性肾细胞癌、1例恶性星形细胞瘤、1例低级别星形细胞瘤、1例少突胶质细胞瘤和1例转移性鳞状细胞癌患者中,发现19例短暂性脑缺血发作和6例完全性卒中。我们记录了肿瘤性和血管性综合征之间的临床重叠情况,并强调在对出现闭塞性脑血管疾病临床表现的非神经科医生诊治的患者进行检查时,需要有“肿瘤意识”。