Abstract
OBJECTIVES
To describe the clinical-radiological characteristics of a monocentric series of patients with stroke due to a state of hypercoagulability associated with cancer.
MATERIAL AND METHODS
We retrospectively reviewed the clinical, radiological and laboratory data of 32 patients diagnosed of ischemic stroke secondary to a state of hypercoagulability associated with cancer between 2007 and 2017.
RESULTS
15/32 were women. The median age was 65 years (range: 48–82). In 4/32 patients, stroke led to the diagnosis of advanced stage cancer, and in 15/32 it occurred in the context of uncontrolled cancer progression. 24/32 patients had at least an additional vascular risk factor. Complementary tests were performed (blood analysis, carotid echo-Doppler, ECG-monitoring, echocardiogram) to rule out other aetiologies. 25/32 patients had acute ischemic lesions in 3 to 5 cerebrovascular territories. 23/32 had multiorgan infarctions in body CT. The D-Dimer was analysed in 14/32 patients, being elevated in 13/14 patients. Half of patients (16/32) suffered a recurrence of stroke in the first 4 weeks. Most frequently detected tumours were lung adenocarcinoma (11/32) and pancreatic adenocarcinoma (8/32). The median survival after the stroke was 1 month (range: 0.2–25 months).
CONCLUSIONS
Uncontrolled cancer may lead to a prothrombotic state that facilitates the development of strokes in multiple cerebrovascular territories. Recurrences are frequent despite anticoagulant therapy, and prognosis is poor because of the underlying cancer and stroke-related neurological deterioration.