Department of Neurology, Beijing Shijingshan Hospital, Shijingshan Teaching Hospital of Capital Medical University, No. 24, Shijingshan Road, Beijing, 100043, China.
Neurol Sci. 2024 Apr;45(4):1537-1547. doi: 10.1007/s10072-023-07180-2. Epub 2023 Nov 13.
Trousseau syndrome (TS) is relatively rare and easily overlooked by clinicians, causing misdiagnosis and affecting subsequent treatment.
In this study, clinical features, laboratory examination, imaging features, treatment, and prognosis of patients with TS were discussed.
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.
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.
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.
特鲁索综合征（TS）较为罕见，易被临床医生忽视，导致误诊，影响后续治疗。
本研究旨在探讨 TS 患者的临床特征、实验室检查、影像学特征、治疗及预后。
回顾性分析 2018 年 2 月至 2022 年 4 月期间在我院神经内科住院的 21 例合并急性缺血性脑卒中（AIS）的恶性肿瘤患者的病例资料，并结合文献进行讨论。
21 例患者中，95.23%（20/21）在恶性肿瘤发病后 6-21 个月发生 AIS，9.52%（2/21）以缺血性脑卒中为首发症状，4.76%（1/21）发生复发性缺血性脑卒中，14.29%（3/21）随后发生静脉及动脉血栓事件；病理确诊为腺癌者占 80.95%（17/21）；梗死灶累及多支血管供血区者占 90.47%（19/21）。MRI 显示多区域、多部位斑片状梗死。所有患者 D-二聚体浓度均高于正常。此外，根据 mRS 评分，61.90%（13/21）的患者预后不良。
TS 是一种罕见的临床类型，常与腺癌相关，其治疗与常规脑梗死不同，预后极差。在临床实践中，对于原因不明的 AIS，如果 MRI 显示多个小病灶，同时 D-二聚体显著升高，建议常规筛查潜在恶性肿瘤。
