Please use this identifier to cite or link to this item: http://hdl.handle.net/11054/1406
Title: Stroke in malignancy: complexities of diagnosis and management: a case report.
Author: Siriratnam, Pakeeran
Kraemer, Thomas
Sahathevan, Ramesh
Issue Date: 2019
Publication Title: Journal of Medical Case Reports
Volume: 13
Issue: 1
Start Page: 260
Abstract: Abstract Background: Although there is an established association between cancer and stroke, the role of malignancy as a causative agent or comorbidity is not always clear. Moreover, there are no established guidelines on the acute treatment of cancer-associated stroke or optimal anticoagulation. This case report illustrates the significance of these practice gaps. Case presentation: A 62-year-old Caucasian woman presented to our institute with acute neurological deficits and was found to have an occluded left middle cerebral artery on a computed tomographic angiogram. She was administered intravenous alteplase and underwent unsuccessful endovascular clot retrieval. Besides smoking and her age, she had no cerebrovascular risk factors, and the results of baseline investigations for the cause of stroke were negative. Subsequent computed tomography of the chest, abdomen, and pelvis showed metastatic malignancy, and in the context of a significantly elevated serum cancer antigen 19-9, we suspected a pancreatic primary cancer. A transthoracic echocardiogram demonstrated mitral regurgitation but no visible vegetation. The patient died of her illness. We made a diagnosis of cancer-associated stroke, specifically a likely case of nonbacterial thrombotic endocarditis. Conclusions: This case highlights the importance of having a high threshold of suspicion for malignancy as a cause of stroke.
URI: http://hdl.handle.net/11054/1406
Resource Link: https://doi.org/10.1186/s13256-019-2183-8
Internal ID Number: 01379
Health Subject: ANTITHROMBOTIC SUBSTANCES
PROCOAGULANT SUBSTANCES
INFLAMMATORY CYTOKINES
MICROPARTICLES
DECONDENSED CHROMATIN
NONBACTERIAL THROMBOTIC ENDOCARDITIS
Type: Journal Article
Article
Appears in Collections:Research Output

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