Wang Lisha, Xu Yan, Tuo Minghui, Zhang Lei, Zhang Hong, Wang Jing
Department of Neurology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City, Hubei Province, People's Republic of China.
Medicine (Baltimore). 2018 Feb;97(5):e9815. doi: 10.1097/MD.0000000000009815.
Repeated occurring stroke in short intervals with hypercoagulability is unusual so in such cases the conventional vascular risk factors might not be the causes of stroke.
We have presented a case of 60-year-old male presenting with recurrent stroke due to thrombophilia.
Lung cancer was detected by superficial lymph nodes ultrasound and further pathological examination.
The patient suffered a recurrent stroke and he had persistently high level of D-dimer which suggested the diagnosis of thrombophilia, thus, he was treated with low-molecular-weight heparin. Unfortunately, the treatment was not effective for the patient and he died before any other treatments could be administered.
Despite anticoagulant therapy, the patient suffered multiple episodes of stroke and ultimately died.
This case of recurrent stroke with coagulation disorders without evidence of cancer in imaging and blood test is rare. So in a stroke patient, we should consider malignancy or metastasis as a differential diagnosis as it may be the first manifestation of active cancer elsewhere.
短时间内反复发生中风且具有高凝性的情况并不常见，因此在这类病例中，传统的血管危险因素可能并非中风的病因。
我们报告了一例60岁男性因血栓形成倾向导致复发性中风的病例。
通过浅表淋巴结超声检查及进一步病理检查发现肺癌。
该患者发生复发性中风，且D-二聚体水平持续升高，提示血栓形成倾向的诊断，因此给予低分子肝素治疗。不幸的是，治疗对该患者无效，在能够进行任何其他治疗之前他就去世了。
尽管进行了抗凝治疗，患者仍多次发生中风并最终死亡。
该例复发性中风伴凝血障碍但影像学和血液检查均无癌症证据的病例很罕见。因此，对于中风患者，我们应考虑将恶性肿瘤或转移作为鉴别诊断，因为这可能是其他部位活动性癌症的首发表现。
