ABSTRACT
Stroke is commonly occurring in a patient with known cancer. Stroke is seldom occur as the first manifestation of a cancer. The majority of these strokes were a consequence of hypercoagulability. We investigated the clinical, laboratory and radiological features of patients whose cancer was firstly diagnosed after time of stroke presentation. We reviewed the clinical, laboratory and radiological records of consecutive stroke patients, whose cancers were diagnosed at stroke presentation. Cancer-related stroke was defined if no definite cause for stroke was confirmed and malignancy was detected within 6 months of first stroke onset without cancer-related treatment. All patients underwent clinical, laboratory and radiological investigations including brain diffusion-weighted MRI [DWI], MR angiography, and echocardiography. The sizes, numbers, and locations of all hyperintense lesions in the DWI were noted. 10 patients were finally analyzed. Lung cancer [40%] and prostate cancer [20%] were the commonest underlying malignancy, they were often of advanced stage. All patients has elevated D-dimer 100%, 5 of them [50%] has highly elevated D-dimer [50%]. 9 of 10 cases [90%] showed bihemispheric numerous and variable size lesions in multiple territories in DWI. Consider a concealed cancer in multiple bihemispheric infarctions in DWI and an unknown etiology