Key result
Cardioembolic stroke dominates in active solid cancer, with multiple acute lesions in ~53% on MRI.
Why the study?
Stroke is more common in cancer patients due to coagulation issues, and establishing etiology is crucial for treatment. The study aimed to evaluate the relationship between diffusion-weighted MRI ischemic lesion topographies and stroke etiology in cancer patients.
Does diffusion restriction pattern on MRI predict stroke etiology in cancer patients?
Observational (n=32)
No
Does diffusion restriction pattern on MRI predict stroke etiology in cancer patients?
In patients with active cancer and acute ischemic stroke, cardioembolic sources are the most common etiology, frequently presenting as multiple embolic lesions on diffusion-weighted MRI.
Multiple DWI lesions may indicate cardioembolic etiology in active cancer stroke; leaves open whether MRI patterns reliably predict mechanism.
BACKGROUND: 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. PATIENTS AND METHODS: 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. RESULTS: 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. CONCLUSION: 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.
No takes yet. Share an insight, caveat, or question.
Asıl et al. (2023) conducted an observational in Acute ischemic stroke and active solid malignancy (n=32). Ischemic lesion topographies on DWI MRI was evaluated on Stroke etiology classification (ASCOD/TOAST) and DWI MRI lesion patterns. Cardioembolic stroke was the most common etiology in patients with active solid malignancies, with multiple acute lesions on diffusion-weighted MRI detected in 53% (17 of 32) of patients.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: