Acute stroke patients have occult malignancy more often than expected.
Jyunichi Uemura1, Kazumi Kimura, Kensaku Sibazaki
1Department of Stroke Medicine, Kawasaki Medical School, Kurashiki, Japan. uemuratrail @ yahoo.co.jp
European Neurology
|July 30, 2010
Summary
Occult malignancy was newly diagnosed in 3.0% of acute ischemic stroke patients. Older age, lower hemoglobin, and higher D-dimer levels were associated with malignancy in stroke patients.
Area of Science:
- Neurology
- Oncology
Background:
- Acute ischemic stroke (AIS) can be a presenting symptom of underlying occult malignancy.
- Identifying patients with AIS who have concurrent malignancy is crucial for timely cancer diagnosis and treatment.
Purpose of the Study:
- To determine the frequency of occult malignancy in patients presenting with AIS.
- To compare the clinical characteristics of AIS patients with and without malignancy.
Main Methods:
- Retrospective analysis of 1,714 consecutive AIS patients admitted within 7 days of symptom onset.
- Patients were categorized into two groups: those with (M group) and without (Non-M group) newly diagnosed malignancy.
- Clinical characteristics, including age, hemoglobin (Hb), and D-dimer levels, were compared between groups.
Main Results:
- A total of 51 patients (3.0%) were diagnosed with malignancy (M group).
- The M group was significantly older than the Non-M group (p = 0.009).
- Patients in the M group exhibited lower Hb levels and higher D-dimer levels compared to the Non-M group (p < 0.001).
- A combination of D-dimer ≥1.3 ng/dL and Hb <12.8 g/dL was significantly associated with a higher likelihood of occult malignancy (p = 0.0088).
Conclusions:
- Occult malignancy is identified in 3.0% of AIS patients.
- Older age, lower hemoglobin, and elevated D-dimer are significant indicators associated with malignancy in AIS patients.
- The combined biomarker D-dimer and Hb may aid in identifying AIS patients with occult malignancy.
Related Concept Videos
01:17Hemorrhagic Stroke l: Introduction
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
01:29Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
01:29Stroke: Introduction and Types
A stroke is an acute neurological event caused by the sudden disruption of cerebral blood flow, leading to rapid loss of neuronal function. Neurons depend on continuous oxygen and glucose supply, so even brief interruptions can cause irreversible injury within minutes. Strokes are classified into ischemic and hemorrhagic types.Ischemic StrokeIschemic strokes are most common and occur due to arterial occlusion, depriving brain tissue of oxygen and nutrients. This leads to energy failure, ionic...
01:15Ischemic Stroke l: Introduction
Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
01:15Ischemic Stroke ll: Pathophysiology
An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...