Kadowaki Makoto, Kamio Yoshinobu, Hiramatsu Hisaya, Namba Hiroki
Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Asian J Neurosurg. 2020 Aug 28;15(3):683-685. doi: 10.4103/ajns.AJNS_83_20. eCollection 2020 Jul-Sep.
Despite the known association between cisplatin and vascular toxicity, the mechanism of cisplatin-associated cerebral infarction, a relatively rare complication, remains unclear. We describe an investigation of potential biomarkers that could facilitate the early detection of this complication in a relevant case.
A 59-year-old male diagnosed with stage III carcinoma of the external auditory canal underwent cisplatin chemotherapy. Seven days after the last dose, he presented with a disturbance of consciousness due to basilar artery occlusion, which was associated with chemotherapy administration. The patient recovered consciousness after thrombectomy. Interestingly, an increase in serum von Willebrand factor (vWf) activity was observed. The vWf activity level gradually normalized 5 months after cisplatin administration.
Endothelial injuries could be responsible for cisplatin-associated cerebral infarction. Moreover, a cisplatin-induced cerebral infarction increase in serum vWf activity, which indicates endothelial injury, suggests that this molecule might be a useful biomarker for predicting cisplatin-associated cerebral infarction.
尽管已知顺铂与血管毒性之间存在关联，但顺铂相关的脑梗死这一相对罕见的并发症的发病机制仍不清楚。我们描述了一项对潜在生物标志物的研究，这些生物标志物有助于在相关病例中早期发现这种并发症。
一名59岁男性被诊断为外耳道III期癌，接受了顺铂化疗。最后一剂化疗后7天，他因基底动脉闭塞出现意识障碍，这与化疗给药有关。患者在血栓切除术后恢复了意识。有趣的是，观察到血清血管性血友病因子（vWf）活性增加。顺铂给药5个月后，vWf活性水平逐渐恢复正常。
内皮损伤可能是顺铂相关脑梗死的原因。此外，顺铂诱导的脑梗死导致血清vWf活性增加，这表明存在内皮损伤，提示该分子可能是预测顺铂相关脑梗死的有用生物标志物。
