Progress of mechanism, diagnosis and treatment of malignant-tumor-related embolic cerebral infarction_West China Medical Journal

Authors：

LIU Ruishan , ZHONG Chenxi ,  ZHANG Shihong

Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

ZHANG Shihong, Email: zsh9@hotmail.com

Keywords：

Cerebral infarction; malignant tumor; embolism; anticoagulation; antiplatelet

DOI：

10.7507/1002-0179.202202119

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

A large amount of research evidence has shown a correlation between cerebral infarction and malignant tumors, and malignant-tumor-related embolic stroke is the main type of malignant-tumor-related cerebral infarction. Hypercoagulation is considered to be the main mechanism. However, due to the complexity of the pathogenesis, the optimal diagnosis, treatment, and prevention strategies remain unclear. This review summarizes the published literature on the concepts, mechanisms, clinical manifestations, laboratory and imaging examinations, treatment and prevention of malignant-tumor-related embolic cerebral infarction, to clearly understand this disease and provide ideas for early recognition, reasonable diagnosis and treatment, improvement of prognosis, and further research of this disease.

Citation： LIU Ruishan, ZHONG Chenxi, ZHANG Shihong. Progress of mechanism, diagnosis and treatment of malignant-tumor-related embolic cerebral infarction. West China Medical Journal, 2022, 37(6): 937-944. doi: 10.7507/1002-0179.202202119 Copy

1.	Zhou M, Wang H, Zeng X, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2019, 394(10204): 1145-1158.
2.	Guzik A, Bushnell C. Stroke epidemiology and risk factor management. Continuum (Minneap Minn), 2017, 23(1): 15-39.
3.	Romeiro AC, Valadas A, Marques J. Acute ischemic stroke on cancer patients, a distinct etiology? A case-control study. Acta Medica Port, 2015, 28(5): 613-618.
4.	Gon Y, Okazaki S, Terasaki Y, et al. Characteristics of cryptogenic stroke in cancer patients. Ann Clin Transl Neurol, 2016, 3(4): 280-287.
5.	Navi BB, Reiner AS, Kamel H, et al. Association between incident cancer and subsequent stroke. Ann Neurol, 2015, 77(2): 291-300.
6.	Zöller B, Ji J, Sundquist J, et al. Risk of haemorrhagic and ischaemic stroke in patients with cancer: a nationwide follow-up study from Sweden. Eur J Cancer, 2012, 48(12): 1875-1883.
7.	Ha J, Lee MJ, Kim SJ, et al. Prevalence and impact of venous and arterial thromboembolism in patients with embolic stroke of undetermined source with or without active cancer. J Am Heart Assoc, 2019, 8(21): e013215.
8.	Hart RG, Catanese L, Perera KS, et al. Embolic stroke of undetermined source: a systematic review and clinical update. Stroke, 2017, 48(4): 867-872.
9.	Sanossian N, Djabiras C, Mack WJ, et al. Trends in cancer diagnoses among inpatients hospitalized with stroke. J Stroke Cerebrovasc Dis, 2013, 22(7): 1146-1150.
10.	Graus F, Rogers LR, Posner JB. Cerebrovascular complications in patients with cancer. Medicine (Baltimore), 1985, 64(1): 16-35.
11.	Kleindorfer DO, Towfighi A, Chaturvedi S, et al. 2021 guideline for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline from the American Heart Association/American Stroke Association. Stroke, 2021, 52(7): e364-e467.
12.	Navi BB, Singer S, Merkler AE, et al. Cryptogenic subtype predicts reduced survival among cancer patients with ischemic stroke. Stroke, 2014, 45(8): 2292-2297.
13.	Schwarzbach CJ, Schaefer A, Ebert A, et al. Stroke and cancer: the importance of cancer-associated hypercoagulation as a possible stroke etiology. Stroke, 2012, 43(11): 3029-3034.
14.	Navi BB, Reiner AS, Kamel H, et al. Risk of arterial thromboembolism in patients with cancer. J Am Coll Cardiol, 2017, 70(8): 926-938.
15.	Bang OY, Chung JW, Lee MJ, et al. Cancer-related stroke: an emerging subtype of ischemic stroke with unique pathomechanisms. J Stroke, 2020, 22(1): 1-10.
16.	Navi BB, Kasner SE, Elkind MSV, et al. Cancer and embolic stroke of undetermined source. Stroke, 2021, 52(3): 1121-1130.
17.	Navi BB, Iadecola C. Ischemic stroke in cancer patients: a review of an underappreciated pathology. Ann Neurol, 2018, 83(5): 873-883.
18.	Hart RG, Diener HC, Coutts SB, et al. Embolic strokes of undetermined source: the case for a new clinical construct. Lancet Neurol, 2014, 13(4): 429-438.
19.	Fonseca AC, Ferro JM. Cryptogenic stroke. Eur J Neurol, 2015, 22(4): 618-623.
20.	Kiyuna F, Sato N, Matsuo R, et al. Association of embolic sources with cause-specific functional outcomes among adults with cryptogenic stroke. JAMA Netw Open, 2018, 1(5): e182953.
21.	Hart RG, Sharma M, Mundl H, et al. Rivaroxaban for stroke prevention after embolic stroke of undetermined source. N Engl J Med, 2018, 378(23): 2191-2201.
22.	Diener HC, Sacco RL, Easton JD, et al. Dabigatran for prevention of stroke after embolic stroke of undetermined source. N Engl J Med, 2019, 380(20): 1906-1917.
23.	Ntaios G, Perlepe K, Lambrou D, et al. Prevalence and overlap of potential embolic sources in patients with embolic stroke of undetermined source. J Am Heart Assoc, 2019, 8(15): e012858.
24.	Kim SJ, Park JH, Lee MJ, et al. Clues to occult cancer in patients with ischemic stroke. PLoS One, 2012, 7(9): e44959.
25.	Bang OY, Chung JW, Lee MJ, et al. Cancer cell-derived extracellular vesicles are associated with coagulopathy causing ischemic stroke via tissue factor-independent way: the OASIS-CANCER Study. PLoS One, 2016, 11(7): e0159170.
26.	Yeh ETH, Chang HM. Cancer and clot: between a rock and a hard place. J Am Coll Cardiol, 2017, 70(8): 939-941.
27.	Leal AC, Mizurini DM, Gomes T, et al. Tumor-derived exosomes induce the formation of neutrophil extracellular traps: implications for the establishment of cancer-associated thrombosis. Sci Rep, 2017, 7(1): 6438.
28.	Seok JM, Kim SG, Kim JW, et al. Coagulopathy and embolic signal in cancer patients with ischemic stroke. Ann Neurol, 2010, 68(2): 213-219.
29.	Liu J, Frishman WH. Nonbacterial thrombotic endocarditis: pathogenesis, diagnosis, and management. Cardiol Rev, 2016, 24(5): 244-247.
30.	Iguchi Y, Kimura K, Kobayashi K, et al. Ischaemic stroke with malignancy may often be caused by paradoxical embolism. J Neurol Neurosurg Psychiatry, 2006, 77(12): 1336-1339.
31.	Lysov Z, Dwivedi DJ, Gould TJ, et al. Procoagulant effects of lung cancer chemotherapy: impact on microparticles and cell-free DNA. Blood Coagul Fibrinolysis, 2017, 28(1): 72-82.
32.	Xu J, Cao Y. Radiation-induced carotid artery stenosis: a comprehensive review of the literature. Interv Neurol, 2014, 2(4): 183-192.
33.	Nakanishi K, Kawano H, Yamagishi Y, et al. Tumor cells detected in retrieved thrombus: cancer-associated stroke. Intern Med, 2021, 60(15): 2491-2494.
34.	Fitzpatrick T, Carrier M, Le Gal G. Cancer, atrial fibrillation, and stroke. Thromb Res, 2017, 155: 101-105.
35.	Sun B, Fan S, Li Z, et al. Clinical and neuroimaging features of acute ischemic stroke in cancer patients. Eur Neurol, 2016, 75(5/6): 292-299.
36.	Motataianu A, Maier S, Andone S, et al. Ischemic stroke in patients with cancer: a retrospective cross-sectional study. J Crit Care Med (Targu Mures), 2021, 7(1): 54-61.
37.	Kim JM, Jung KH, Park KH, et al. Clinical manifestation of cancer related stroke: retrospective case-control study. J Neurooncol, 2013, 111(3): 295-301.
38.	Yeşilot N, Ekizoğlu E, Çoban O. Clinical features of cancer associated ischemic stroke. Noro Psikiyatr Ars, 2018, 55(2): 113-117.
39.	Reagan TJ, Okazaki H. The thrombotic syndrome associated with carcinoma. A clinical and neuropathologic study. Arch Neurol, 1974, 31(6): 390-395.
40.	Grazioli S, Paciaroni M, Agnelli G, et al. Cancer-associated ischemic stroke: a retrospective multicentre cohort study. Thromb Res, 2018, 165: 33-37.
41.	Gon Y, Sakaguchi M, Takasugi J, et al. Plasma D-dimer levels and ischaemic lesions in multiple vascular regions can predict occult cancer in patients with cryptogenic stroke. Eur J Neurol, 2017, 24(3): 503-508.
42.	Quintas S, Rogado J, Gullón P, et al. Predictors of unknown cancer in patients with ischemic stroke. J Neurooncol, 2018, 137(3): 551-557.
43.	Kassubek R, Bullinger L, Kassubek J, et al. Identifying ischemic stroke associated with cancer:a multiple model derived from a case-control analysis. J Neurol, 2017, 264(4): 781-791.
44.	Lee MJ, Chung JW, Ahn MJ, et al. Hypercoagulability and mortality of patients with stroke and active cancer: the OASIS-CANCER Study. J Stroke, 2017, 19(1): 77-87.
45.	Ohara T, Farhoudi M, Bang OY, et al. The emerging value of serum D-dimer measurement in the work-up and management of ischemic stroke. Int J Stroke, 2020, 15(2): 122-131.
46.	谭蕾蕾, 贾燕, 李鹏辉, 等. 恶性肿瘤相关脑梗死的临床特征分析. 中国实用神经疾病杂志, 2020, 23(8): 645-649.
47.	Nam KW, Kim CK, Kim TJ, et al. D-dimer as a predictor of early neurologic deterioration in cryptogenic stroke with active cancer. Eur J Neurol, 2017, 24(1): 205-211.
48.	Nouh AM, Staff I, Finelli PF. Three territory sign: an MRI marker of malignancy-related ischemic stroke (Trousseau syndrome). Neurol Clin Pract, 2019, 9(2): 124-128.
49.	Achiha T, Takagaki M, Oe H, et al. Voxel-based lesion mapping of cryptogenic stroke in patients with advanced cancer: a detailed magnetic resonance imaging analysis of distribution pattern. J Stroke Cerebrovasc Dis, 2017, 26(7): 1521-1527.
50.	Merkler AE, Navi BB, Singer S, et al. Diagnostic yield of echocardiography in cancer patients with ischemic stroke. J Neurooncol, 2015, 123(1): 115-121.
51.	Cramer SC, Rordorf G, Maki JH, et al. Increased pelvic vein thrombi in cryptogenic stroke: results of the Paradoxical Emboli from Large Veins in Ischemic Stroke (PELVIS) study. Stroke, 2004, 35(1): 46-50.
52.	Fugate JE, Rabinstein AA. Absolute and relative contraindications to Ⅳ rt-PA for acute ischemic stroke. Neurohospitalist, 2015, 5(3): 110-121.
53.	Murthy SB, Karanth S, Shah S, et al. Thrombolysis for acute ischemic stroke in patients with cancer: a population study. Stroke, 2013, 44(12): 3573-3576.
54.	Cappellari M, Carletti M, Micheletti N, et al. Intravenous alteplase for acute ischemic stroke in patients with current malignant neoplasm. J Neurol Sci, 2013, 325(1/2): 100-102.
55.	Sobolewski P, Brola W, Szczuchniak W, et al. Safety of intravenous thrombolysis for acute ischaemic stroke including concomitant neoplastic disease sufferers - experience from Poland. Int J Clin Pract, 2015, 69(6): 666-673.
56.	Jung S, Jung C, Hyoung Kim J, et al. Procedural and clinical outcomes of endovascular recanalization therapy in patients with cancer-related stroke. Interv Neuroradiol, 2018, 24(5): 520-528.
57.	Park H, Kim J, Ha J, et al. Histological features of intracranial thrombi in stroke patients with cancer. Ann Neurol, 2019, 86(1): 143-149.
58.	Li N. Platelets in cancer metastasis: to help the “villain” to do evil. Int J Cancer, 2016, 138(9): 2078-2087.
59.	Kamphuisen PW, Beyer-Westendorf J. Bleeding complications during anticoagulant treatment in patients with cancer. Thromb Res, 2014, 133(Suppl 2): S49-S55.
60.	Key NS, Khorana AA, Kuderer NM, et al. Venous thromboembolism prophylaxis and treatment in patients with cancer: ASCO clinical practice guideline update. J Clin Oncol, 2020, 38(5): 496-520.
61.	Jang H, Lee JJ, Lee MJ, et al. Comparison of enoxaparin and warfarin for secondary prevention of cancer-associated stroke. J Oncol, 2015, 2015: 502089.
62.	Rose AJ, Sharman JP, Ozonoff A, et al. Effectiveness of warfarin among patients with cancer. J Gen Intern Med, 2007, 22(7): 997-1002.
63.	Hsu JY, Liu AB. Anticoagulants for cancer-associated ischemic stroke. Ci Ji Yi Xue Za Zhi, 2019, 31(3): 144-148.
64.	Nam KW, Kim CK, Kim TJ, et al. Treatment of cryptogenic stroke with active cancer with a new oral anticoagulant. J Stroke Cerebrovasc Dis, 2017, 26(12): 2976-2980.
65.	Atterman A, Asplund K, Friberg L, et al. Use of oral anticoagulants after ischaemic stroke in patients with atrial fibrillation and cancer. J Intern Med, 2020, 288(4): 457-468.
66.	Naito H, Nezu T, Hosomi N, et al. Antithrombotic therapy strategy for cancer-associated ischemic stroke: a case series of 26 patients. J Stroke Cerebrovasc Dis, 2018, 27(9): e206-e211.
67.	Short NJ, Connors JM. New oral anticoagulants and the cancer patient. Oncologist, 2014, 19(1): 82-93.
68.	Navi BB, Marshall RS, Bobrow D, et al. Enoxaparin vs aspirin in patients with cancer and ischemic stroke: the TEACH pilot randomized clinical trial. JAMA Neurol, 2018, 75(3): 379-381.
69.	Martinez-Majander N, Ntaios G, Liu YY, et al. Rivaroxaban versus aspirin for secondary prevention of ischaemic stroke in patients with cancer: a subgroup analysis of the NAVIGATE ESUS randomized trial. Eur J Neurol, 2020, 27(5): 841-848.
70.	Shin YW, Lee ST, Jung KH, et al. Predictors of survival for patients with cancer after cryptogenic stroke. J Neurooncol, 2016, 128(2): 277-284.
71.	王继蕊, 林梅青, 赵久晗, 等. 合并恶性肿瘤的脑梗死的临床特点及影响预后的相关因素分析. 中国卒中杂志, 2021, 16(2): 136-140.
72.	Navi BB, Singer S, Merkler AE, et al. Recurrent thromboembolic events after ischemic stroke in patients with cancer. Neurology, 2014, 83(1): 26-33.
73.	Navi BB, Kamel H, Sidney S, et al. Validation of the Stroke Prognostic Instrument-Ⅱ in a large, modern, community-based cohort of ischemic stroke survivors. Stroke, 2011, 42(12): 3392-3396.

1. Zhou M, Wang H, Zeng X, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 2019, 394(10204): 1145-1158.
2. Guzik A, Bushnell C. Stroke epidemiology and risk factor management. Continuum (Minneap Minn), 2017, 23(1): 15-39.
3. Romeiro AC, Valadas A, Marques J. Acute ischemic stroke on cancer patients, a distinct etiology? A case-control study. Acta Medica Port, 2015, 28(5): 613-618.
4. Gon Y, Okazaki S, Terasaki Y, et al. Characteristics of cryptogenic stroke in cancer patients. Ann Clin Transl Neurol, 2016, 3(4): 280-287.
5. Navi BB, Reiner AS, Kamel H, et al. Association between incident cancer and subsequent stroke. Ann Neurol, 2015, 77(2): 291-300.
6. Zöller B, Ji J, Sundquist J, et al. Risk of haemorrhagic and ischaemic stroke in patients with cancer: a nationwide follow-up study from Sweden. Eur J Cancer, 2012, 48(12): 1875-1883.
7. Ha J, Lee MJ, Kim SJ, et al. Prevalence and impact of venous and arterial thromboembolism in patients with embolic stroke of undetermined source with or without active cancer. J Am Heart Assoc, 2019, 8(21): e013215.
8. Hart RG, Catanese L, Perera KS, et al. Embolic stroke of undetermined source: a systematic review and clinical update. Stroke, 2017, 48(4): 867-872.
9. Sanossian N, Djabiras C, Mack WJ, et al. Trends in cancer diagnoses among inpatients hospitalized with stroke. J Stroke Cerebrovasc Dis, 2013, 22(7): 1146-1150.
10. Graus F, Rogers LR, Posner JB. Cerebrovascular complications in patients with cancer. Medicine (Baltimore), 1985, 64(1): 16-35.
11. Kleindorfer DO, Towfighi A, Chaturvedi S, et al. 2021 guideline for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline from the American Heart Association/American Stroke Association. Stroke, 2021, 52(7): e364-e467.
12. Navi BB, Singer S, Merkler AE, et al. Cryptogenic subtype predicts reduced survival among cancer patients with ischemic stroke. Stroke, 2014, 45(8): 2292-2297.
13. Schwarzbach CJ, Schaefer A, Ebert A, et al. Stroke and cancer: the importance of cancer-associated hypercoagulation as a possible stroke etiology. Stroke, 2012, 43(11): 3029-3034.
14. Navi BB, Reiner AS, Kamel H, et al. Risk of arterial thromboembolism in patients with cancer. J Am Coll Cardiol, 2017, 70(8): 926-938.
15. Bang OY, Chung JW, Lee MJ, et al. Cancer-related stroke: an emerging subtype of ischemic stroke with unique pathomechanisms. J Stroke, 2020, 22(1): 1-10.
16. Navi BB, Kasner SE, Elkind MSV, et al. Cancer and embolic stroke of undetermined source. Stroke, 2021, 52(3): 1121-1130.
17. Navi BB, Iadecola C. Ischemic stroke in cancer patients: a review of an underappreciated pathology. Ann Neurol, 2018, 83(5): 873-883.
18. Hart RG, Diener HC, Coutts SB, et al. Embolic strokes of undetermined source: the case for a new clinical construct. Lancet Neurol, 2014, 13(4): 429-438.
19. Fonseca AC, Ferro JM. Cryptogenic stroke. Eur J Neurol, 2015, 22(4): 618-623.
20. Kiyuna F, Sato N, Matsuo R, et al. Association of embolic sources with cause-specific functional outcomes among adults with cryptogenic stroke. JAMA Netw Open, 2018, 1(5): e182953.
21. Hart RG, Sharma M, Mundl H, et al. Rivaroxaban for stroke prevention after embolic stroke of undetermined source. N Engl J Med, 2018, 378(23): 2191-2201.
22. Diener HC, Sacco RL, Easton JD, et al. Dabigatran for prevention of stroke after embolic stroke of undetermined source. N Engl J Med, 2019, 380(20): 1906-1917.
23. Ntaios G, Perlepe K, Lambrou D, et al. Prevalence and overlap of potential embolic sources in patients with embolic stroke of undetermined source. J Am Heart Assoc, 2019, 8(15): e012858.
24. Kim SJ, Park JH, Lee MJ, et al. Clues to occult cancer in patients with ischemic stroke. PLoS One, 2012, 7(9): e44959.
25. Bang OY, Chung JW, Lee MJ, et al. Cancer cell-derived extracellular vesicles are associated with coagulopathy causing ischemic stroke via tissue factor-independent way: the OASIS-CANCER Study. PLoS One, 2016, 11(7): e0159170.
26. Yeh ETH, Chang HM. Cancer and clot: between a rock and a hard place. J Am Coll Cardiol, 2017, 70(8): 939-941.
27. Leal AC, Mizurini DM, Gomes T, et al. Tumor-derived exosomes induce the formation of neutrophil extracellular traps: implications for the establishment of cancer-associated thrombosis. Sci Rep, 2017, 7(1): 6438.
28. Seok JM, Kim SG, Kim JW, et al. Coagulopathy and embolic signal in cancer patients with ischemic stroke. Ann Neurol, 2010, 68(2): 213-219.
29. Liu J, Frishman WH. Nonbacterial thrombotic endocarditis: pathogenesis, diagnosis, and management. Cardiol Rev, 2016, 24(5): 244-247.
30. Iguchi Y, Kimura K, Kobayashi K, et al. Ischaemic stroke with malignancy may often be caused by paradoxical embolism. J Neurol Neurosurg Psychiatry, 2006, 77(12): 1336-1339.
31. Lysov Z, Dwivedi DJ, Gould TJ, et al. Procoagulant effects of lung cancer chemotherapy: impact on microparticles and cell-free DNA. Blood Coagul Fibrinolysis, 2017, 28(1): 72-82.
32. Xu J, Cao Y. Radiation-induced carotid artery stenosis: a comprehensive review of the literature. Interv Neurol, 2014, 2(4): 183-192.
33. Nakanishi K, Kawano H, Yamagishi Y, et al. Tumor cells detected in retrieved thrombus: cancer-associated stroke. Intern Med, 2021, 60(15): 2491-2494.
34. Fitzpatrick T, Carrier M, Le Gal G. Cancer, atrial fibrillation, and stroke. Thromb Res, 2017, 155: 101-105.
35. Sun B, Fan S, Li Z, et al. Clinical and neuroimaging features of acute ischemic stroke in cancer patients. Eur Neurol, 2016, 75(5/6): 292-299.
36. Motataianu A, Maier S, Andone S, et al. Ischemic stroke in patients with cancer: a retrospective cross-sectional study. J Crit Care Med (Targu Mures), 2021, 7(1): 54-61.
37. Kim JM, Jung KH, Park KH, et al. Clinical manifestation of cancer related stroke: retrospective case-control study. J Neurooncol, 2013, 111(3): 295-301.
38. Yeşilot N, Ekizoğlu E, Çoban O. Clinical features of cancer associated ischemic stroke. Noro Psikiyatr Ars, 2018, 55(2): 113-117.
39. Reagan TJ, Okazaki H. The thrombotic syndrome associated with carcinoma. A clinical and neuropathologic study. Arch Neurol, 1974, 31(6): 390-395.
40. Grazioli S, Paciaroni M, Agnelli G, et al. Cancer-associated ischemic stroke: a retrospective multicentre cohort study. Thromb Res, 2018, 165: 33-37.
41. Gon Y, Sakaguchi M, Takasugi J, et al. Plasma D-dimer levels and ischaemic lesions in multiple vascular regions can predict occult cancer in patients with cryptogenic stroke. Eur J Neurol, 2017, 24(3): 503-508.
42. Quintas S, Rogado J, Gullón P, et al. Predictors of unknown cancer in patients with ischemic stroke. J Neurooncol, 2018, 137(3): 551-557.
43. Kassubek R, Bullinger L, Kassubek J, et al. Identifying ischemic stroke associated with cancer:a multiple model derived from a case-control analysis. J Neurol, 2017, 264(4): 781-791.
44. Lee MJ, Chung JW, Ahn MJ, et al. Hypercoagulability and mortality of patients with stroke and active cancer: the OASIS-CANCER Study. J Stroke, 2017, 19(1): 77-87.
45. Ohara T, Farhoudi M, Bang OY, et al. The emerging value of serum D-dimer measurement in the work-up and management of ischemic stroke. Int J Stroke, 2020, 15(2): 122-131.
46. 谭蕾蕾, 贾燕, 李鹏辉, 等. 恶性肿瘤相关脑梗死的临床特征分析. 中国实用神经疾病杂志, 2020, 23(8): 645-649.
47. Nam KW, Kim CK, Kim TJ, et al. D-dimer as a predictor of early neurologic deterioration in cryptogenic stroke with active cancer. Eur J Neurol, 2017, 24(1): 205-211.
48. Nouh AM, Staff I, Finelli PF. Three territory sign: an MRI marker of malignancy-related ischemic stroke (Trousseau syndrome). Neurol Clin Pract, 2019, 9(2): 124-128.
49. Achiha T, Takagaki M, Oe H, et al. Voxel-based lesion mapping of cryptogenic stroke in patients with advanced cancer: a detailed magnetic resonance imaging analysis of distribution pattern. J Stroke Cerebrovasc Dis, 2017, 26(7): 1521-1527.
50. Merkler AE, Navi BB, Singer S, et al. Diagnostic yield of echocardiography in cancer patients with ischemic stroke. J Neurooncol, 2015, 123(1): 115-121.
51. Cramer SC, Rordorf G, Maki JH, et al. Increased pelvic vein thrombi in cryptogenic stroke: results of the Paradoxical Emboli from Large Veins in Ischemic Stroke (PELVIS) study. Stroke, 2004, 35(1): 46-50.
52. Fugate JE, Rabinstein AA. Absolute and relative contraindications to Ⅳ rt-PA for acute ischemic stroke. Neurohospitalist, 2015, 5(3): 110-121.
53. Murthy SB, Karanth S, Shah S, et al. Thrombolysis for acute ischemic stroke in patients with cancer: a population study. Stroke, 2013, 44(12): 3573-3576.
54. Cappellari M, Carletti M, Micheletti N, et al. Intravenous alteplase for acute ischemic stroke in patients with current malignant neoplasm. J Neurol Sci, 2013, 325(1/2): 100-102.
55. Sobolewski P, Brola W, Szczuchniak W, et al. Safety of intravenous thrombolysis for acute ischaemic stroke including concomitant neoplastic disease sufferers - experience from Poland. Int J Clin Pract, 2015, 69(6): 666-673.
56. Jung S, Jung C, Hyoung Kim J, et al. Procedural and clinical outcomes of endovascular recanalization therapy in patients with cancer-related stroke. Interv Neuroradiol, 2018, 24(5): 520-528.
57. Park H, Kim J, Ha J, et al. Histological features of intracranial thrombi in stroke patients with cancer. Ann Neurol, 2019, 86(1): 143-149.
58. Li N. Platelets in cancer metastasis: to help the “villain” to do evil. Int J Cancer, 2016, 138(9): 2078-2087.
59. Kamphuisen PW, Beyer-Westendorf J. Bleeding complications during anticoagulant treatment in patients with cancer. Thromb Res, 2014, 133(Suppl 2): S49-S55.
60. Key NS, Khorana AA, Kuderer NM, et al. Venous thromboembolism prophylaxis and treatment in patients with cancer: ASCO clinical practice guideline update. J Clin Oncol, 2020, 38(5): 496-520.
61. Jang H, Lee JJ, Lee MJ, et al. Comparison of enoxaparin and warfarin for secondary prevention of cancer-associated stroke. J Oncol, 2015, 2015: 502089.
62. Rose AJ, Sharman JP, Ozonoff A, et al. Effectiveness of warfarin among patients with cancer. J Gen Intern Med, 2007, 22(7): 997-1002.
63. Hsu JY, Liu AB. Anticoagulants for cancer-associated ischemic stroke. Ci Ji Yi Xue Za Zhi, 2019, 31(3): 144-148.
64. Nam KW, Kim CK, Kim TJ, et al. Treatment of cryptogenic stroke with active cancer with a new oral anticoagulant. J Stroke Cerebrovasc Dis, 2017, 26(12): 2976-2980.
65. Atterman A, Asplund K, Friberg L, et al. Use of oral anticoagulants after ischaemic stroke in patients with atrial fibrillation and cancer. J Intern Med, 2020, 288(4): 457-468.
66. Naito H, Nezu T, Hosomi N, et al. Antithrombotic therapy strategy for cancer-associated ischemic stroke: a case series of 26 patients. J Stroke Cerebrovasc Dis, 2018, 27(9): e206-e211.
67. Short NJ, Connors JM. New oral anticoagulants and the cancer patient. Oncologist, 2014, 19(1): 82-93.
68. Navi BB, Marshall RS, Bobrow D, et al. Enoxaparin vs aspirin in patients with cancer and ischemic stroke: the TEACH pilot randomized clinical trial. JAMA Neurol, 2018, 75(3): 379-381.
69. Martinez-Majander N, Ntaios G, Liu YY, et al. Rivaroxaban versus aspirin for secondary prevention of ischaemic stroke in patients with cancer: a subgroup analysis of the NAVIGATE ESUS randomized trial. Eur J Neurol, 2020, 27(5): 841-848.
70. Shin YW, Lee ST, Jung KH, et al. Predictors of survival for patients with cancer after cryptogenic stroke. J Neurooncol, 2016, 128(2): 277-284.
71. 王继蕊, 林梅青, 赵久晗, 等. 合并恶性肿瘤的脑梗死的临床特点及影响预后的相关因素分析. 中国卒中杂志, 2021, 16(2): 136-140.
72. Navi BB, Singer S, Merkler AE, et al. Recurrent thromboembolic events after ischemic stroke in patients with cancer. Neurology, 2014, 83(1): 26-33.
73. Navi BB, Kamel H, Sidney S, et al. Validation of the Stroke Prognostic Instrument-Ⅱ in a large, modern, community-based cohort of ischemic stroke survivors. Stroke, 2011, 42(12): 3392-3396.

West China Medical Journal

Progress of mechanism, diagnosis and treatment of malignant-tumor-related embolic cerebral infarction

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content