Department of Neurology, Bezmialem Vakıf University, Istanbul, Turkey.
Department of Neurology, Memorial Hizmet Hospital, Istanbul, Turkey.
Curr Med Imaging. 2023;19(8):931-938. doi: 10.2174/1573405619666221230115119.
Stroke and cancer are two of the most common health problems. Moreover, stroke is more common in patients with cancer than in the normal population, due to coagulation problems. Knowing the etiology of stroke is important for determining treatment options. This study aimed to determine the relationship between ischemic lesion topographies using diffusion-weighted magnetic resonance imaging (MRI) and the etiology of stroke in patients with cancer.
All patients with ischemic stroke in the Bezmialem Stroke Registry over a 4- year period were retrospectively analyzed in this study. Patients with acute ischemic stroke and additional diagnoses of solid and active malignancy (excluding hematologic malignancies) were included in the analysis. We investigated whether there was a relationship between the etiology of patients with cancer-related stroke according to the stroke etiologic classification and the diffusion restriction patterns on MRI.
In this registry, 32 of 1472 patients were diagnosed as having active cancer. Fourteen patients were evaluated as having definite cardioembolism, eight patients as probable cardioembolism, and four patients had inadequate examinations. Only one patient was classified as having an atherothrombotic stroke. Isolated acute infarction was seen in 15 of 32 patients. In patients with multiple acute infarct areas (n=17), acute lesions characterized by micro embolisms in a single vessel area were detected in four patients, and acute lesions characterized by bilateral (anterior and/or posterior system) micro embolisms in more than one vessel area in 13 patients.
The most common etiology of stroke in patients with cancer was found to be embolic/ cardioembolic. This is important for the treatment plans for ischemic stroke in patients with cancer.
中风和癌症是两种最常见的健康问题。此外，由于凝血问题，癌症患者中风的发病率高于普通人群。了解中风的病因对于确定治疗方案很重要。本研究旨在确定使用弥散加权磁共振成像（MRI）的缺血性病变拓扑结构与癌症患者中风病因之间的关系。
本研究回顾性分析了 Bezmialem 中风登记处 4 年内所有缺血性中风患者。将急性缺血性中风且伴有实体和活动性恶性肿瘤（不包括血液恶性肿瘤）的患者纳入分析。我们研究了根据中风病因分类和 MRI 上弥散受限模式，癌症相关中风患者的病因是否存在关系。
在该登记处，1472 名患者中诊断出 32 名患有活动性癌症。14 名患者被评估为明确的心源性栓塞，8 名患者为可能的心源性栓塞，4 名患者检查不充分。只有 1 名患者被归类为动脉粥样硬化血栓性中风。32 名患者中有 15 名出现孤立性急性梗死。在 17 名出现多个急性梗死灶的患者中，4 名患者在单个血管区域发现急性微栓塞病变，13 名患者在多个血管区域发现双侧（前、后系统）微栓塞病变。
癌症患者中风的最常见病因是栓塞/心源性栓塞。这对于癌症患者缺血性中风的治疗计划很重要。
