ABSTRACT
Objective:To analyze the clinical characteristics of lung cancer associated acute ischemic stroke (LCA-AIS) and atrial fibrillation associated acute ischemic stroke (AFA-AIS).Methods:From January 1, 2014 to December 31, 2018, 46 patients diagnosed with LCA-AIS (LCA-AIS group)in Hainan Hospital of Chinese PLA General Hospital were selected, and 46 patients diagnosed with AFA-AIS (AFA-AIS group) were matched according to age and sex.The general situation, laboratory test results and imaging results of the two groups were analyzed.Results:(1) The neurological deficit symptoms in AFA-AIS group were more serious than those in LCA-AIS group; there was significant difference in National Institutes of Health Stroke Scale (NIHSS) score and the Modified Rankin Scale (mRs) score between the two groups ( P=0.001, P=0.003). (2)The D-D polymer concentration in LCA-AIS group was significantly higher than that in AFA-AIS group ( P<0.001), but the hemoglobin, erythrocyte count and hematocrit were significantly lower than those in AFA-AIS group (all P<0.001). (3)There was no significant difference in imaging classification and the number of infarct basins between LCA-AIS group and AFA-AIS group ( P>0.05). LCA-AIS patients was more likely to have poly-period acute ischemic lesions ( P=0.015), while AFA-AIS had significantly larger infarct diameter and more likely to be complicated with acute hemorrhagic stroke or bleeding ( P<0.001). Conclusions:The clinical characteristics of LCA-AIS and AFA-AIS are similar, so it is necessary to distinguish LCA-AIS from AFA-AIS in combination with neurological impairment, laboratory tests and imaging findings to avoid misdiagnosis.
ABSTRACT
Objective To analyze the mechanism of acute ischemic stroke in cancer patients. Methods The clinical TOAST type, laboratory examinations results, imaging examination results and pathology reports of the 96 patients with cancer and acute cerebral infarction were collected. Results According to TOAST mechanism, the main subtype was undetermined causes (41.67%, 40/96). Lung cancer took largest proportion (39.58%, 38/96). In the group of undetermined causes, adenocarcinoma was more common type than squamous. The imaging examination results could be classified into large artery type, large artery and small artery in same basin and multiple small arterys in different basins. We found the main type was multiple small arterys in different basins (52.50%, 21/40). The lever of D-dimer was high in our patients, especially in undetermined causes (P < 0.01). Conclusions Tumor-related acute cerebral infarction has its own uinque mechanism. Tumor is one kind of systemic diseases, which can promote thrombosis through increasing the lever of D-dimer. The cancer-related mechanism is the main mechanism underlying cancer- related stroke, and may become one of the most important mechanismsn in the pathogenesis of stroke in the near future.