Ischemic Stroke in Critically Ill Patients with Malignancy

作者：Jeong-Am Ryu, Oh Young Bang, Gee Young Suh, Jeong Hoon Yang, Dae-Sang Lee, Jinkyeong Park, Joongbum Cho, Chi Ryang Chung, Chi-Min Park, Kyeongman Jeon · 发表于：PLoS ONE · 年份：2016 · DOI：10.1371/journal.pone.0146836 · 被引用次数：3 · 研究领域：Acute Ischemic Stroke Management、Chemotherapy-induced cardiotoxicity and mitigation、Neurological Complications and Syndromes

BACKGROUND: Cerebrovascular diseases are a frequent cause of neurological symptoms in patients with cancer. The clinical characteristics of ischemic stroke (IS) in patients with cancer have been reported in several studies; however, limited data are available regarding critically ill patients with cancer who develop IS during their stay in the intensive care unit (ICU). METHODS: All consecutive patients who underwent brain magnetic resonance imaging (MRI) for suspicion of IS with acute abnormal neurologic symptoms or who developed signs of IS while in the ICU were retrospectively evaluated. We compared the clinical characteristics and diffusion-weighted imaging (DWI) lesion patterns between patients finally diagnosed as having or not having IS. RESULTS: Over the study period, a total of 88 patients underwent brain MRI for suspicion of IS, with altered mental status in 55 (63%), hemiparesis in 28 (32%), and seizure in 20 (23%). A total of 43 (49%) patients were ultimately diagnosed with IS. Multiple DWI lesions (41%) were more common than single lesions (8%). The etiologies of IS were not determined in the majority of patients (n = 27, 63%). In the remaining 16 (37%) patients, the most common aetiology of IS was cardioembolism (n = 8), followed by large-vessel atherosclerosis (n = 3) and small-vessel occlusion (n = 2). However, brain metastases were newly diagnosed in only 7 (8%) patients. Univariate comparison of the baseline characteristics between patients with or without I...