Trousseau Syndrome as a Cuase of Ischemic Stroke in the Young
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Keywords

Ischemic Stroke
Ovarian Adenocarcinoma
Trousseau Syndrome

Categories

How to Cite

Trousseau Syndrome as a Cuase of Ischemic Stroke in the Young. (2020). Ictus, 1(1), e30092001006. https://doi.org/10.5281/zenodo.4075407

Abstract

Trousseau syndrome is characterized by the presence of venous or arterial thrombotic events associated with a patient with visceral cancer. We present the case of a 43-year-old woman previously healthy, who presented a clinical picture of systemic embolisms with fever and who developed multiple strokes with embolic features. The progression and multiple-event symptoms with fever and multiple use of antibiotics raised the suspicion of bacterial endocarditis as the first possibility. She was admitted to hospital due to recurrence of ischemic stroke despite aspirin treatment, for diagnosis and treatment. The presence of non-bacterial endocarditis associated with ovarian carcinoma was confirmed, making the diagnosis of Trousseau syndrome feasible. The patient's hospital evolution was torpid, presenting cerebral hemorrhage associated with anticoagulants, systemic complications, and finally death of the patient 61 days after the first symptom.

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References

Adams HP, Bendixen BH, Kappelle LJ, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke. 1993;24(1):35-41. doi:10.1161/01.STR.24.1.35

Amarenco P, Bogousslavsky J, Caplan LR, Donnan GA, Hennerici MG. New Approach to Stroke Subtyping: The A-S-C-O (Phenotypic) Classification of Stroke. Cerebrovasc Dis. 2009;27(5):502-508. doi:10.1159/000210433

Smajlovic D. Strokes in young adults: epidemiology and prevention. Vasc Health Risk Manag. February 2015:157. doi:10.2147/VHRM.S53203

Nedeltchev K. Ischaemic stroke in young adults: predictors of outcome and recurrence. J Neurol Neurosurg Psychiatry. 2005;76(2):191-195. doi:10.1136/jnnp.2004.040543

GRAUS F, ROGERS LR, POSNER JB. Cerebrovascular Complications in Patients with Cancer. Medicine (Baltimore). 1985;64(1):16-35. doi:10.1097/00005792-198501000-00002

Dardiotis E, Aloizou A-M, Markoula S, et al. Cancer-associated stroke: Pathophysiology, detection and management (Review). Int J Oncol. January 2019. doi:10.3892/ijo.2019.4669

Cestari DM, Weine DM, Panageas KS, Segal AZ, DeAngelis LM. Stroke in patients with cancer: Incidence and etiology. Neurology. 2004;62(11):2025-2030. doi:10.1212/01.WNL.0000129912.56486.2B

Selvik HA, Thomassen L, Logallo N, Naess H. Prior Cancer in Patients with Ischemic Stroke: The Bergen NORSTROKE Study. J Stroke Cerebrovasc Dis. 2014;23(5):919-925. doi:10.1016/j.jstrokecerebrovasdis.2013.07.041

Selvik HA, Thomassen L, Bjerkreim AT, Naess H. Cancer-Associated Stroke: The Bergen NORSTROKE Study. Cerebrovasc Dis Extra. 2015;5(3):107-113. doi:10.1159/000440730

Sanossian N, Djabiras C, Mack WJ, Ovbiagele B. Trends in Cancer Diagnoses among Inpatients Hospitalized with Stroke. J Stroke Cerebrovasc Dis. 2013;22(7):1146-1150. doi:10.1016/j.jstrokecerebrovasdis.2012.11.016

Stefan O, Vera N, Otto B, Heinz L, Wolfgang G. Stroke in cancer patients: a risk factor analysis. J Neurooncol. 2009;94(2):221-226. doi:10.1007/s11060-009-9818-3

Navi BB, Reiner AS, Kamel H, et al. Association between incident cancer and subsequent stroke. Ann Neurol. 2015;77(2):291-300. doi:10.1002/ana.24325

Blom JW. Malignancies, Prothrombotic Mutations, and the Risk of Venous Thrombosis. JAMA. 2005;293(6):715. doi:10.1001/jama.293.6.715

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. doi:10.1016/j.jacc.2017.06.047

Varki A. Trousseau’s syndrome: multiple definitions and multiple mechanisms. Blood. 2007;110(6):1723-1729. doi:10.1182/blood-2006-10-053736

De Stefano V. Arterial thrombosis and cancer: the neglected side of the coin of Trousseau syndrome. Haematologica. 2018;103(9):1419-1421. doi:10.3324/haematol.2018.197814

Sack GH, Levin J, Bell WR. Trousseau’s syndrome and other manifestations of chronic disseminated coagulopathy in patients with neoplasms: clinical, pathophysiologic, and therapeutic features. Medicine (Baltimore). 1977;56(1):1-37. http://www.ncbi.nlm.nih.gov/pubmed/834136.

Hasegawa Y, Setoguchi T, Sakaida T, Iuchi T. Utility of a scoring system for differentiating cancer-associated stroke from cryptogenic stroke in patients with cancer. Neurol Sci. 2020;41(5):1245-1250. doi:10.1007/s10072-019-04231-5

Karlińska AG, Gromadzka G, Karliński MA, Członkowska A. The Activity of Malignancy May Determine Stroke Pattern in Cancer Patients. J Stroke Cerebrovasc Dis. 2015;24(4):778-783. doi:10.1016/j.jstrokecerebrovasdis.2014.11.003

Dearborn J, Urrutia V, Zeiler S. Stroke and Cancer- A Complicated Relationship. J Neurol Transl Neurosc. 2014;2(1):1039.

Borowski A, Ghodsizad A, Gams E. Stroke as a first manifestation of ovarian cancer. J Neurooncol. 2005;71(3):267-269. doi:10.1007/s11060-004-1394-y

Potugari BR, Priyanka P, Komanapalli SD, Mercier RJ. Ovarian Cancer Presenting as Cryptogenic Stroke from Patent Foramen Ovale. Clin Med Res. 2019;17(3-4):97-101. doi:10.3121/cmr.2019.1444

Kunitake K, Inagaki R, Furukawa S, Kitagawa S, Oguchi H, Ito Y. Alternating Amaurosis Fugax in Trousseau Syndrome: A Case Report. J Stroke Cerebrovasc Dis. 2019;28(7):e92-e94. doi:10.1016/j.jstrokecerebrovasdis.2019.04.018

Winter WE, Seidman J, Krivak TC, Pujari SG, Boice CR, Carlson JW. Papillary Serous Adenocarcinoma of the Ovary Diagnosed after Malignant Pericardial Tamponade and Embolic Stroke. Gynecol Oncol. 2002;84(3):453-455. doi:10.1006/gyno.2001.6505

Kanthasamy V, Natarajan I. Rare and challenging case of stroke as a manifestation of non bacterial thrombotic endocarditis in an underlying ovarian clear cell carcinoma. JRSM Open. 2016;7(11):205427041666930. doi:10.1177/2054270416669304

Lin Y-K, Lee J-T, Yang F-C, et al. Systemic embolic events with nonbacterial thrombotic endocarditis as manifestations of recurrent ovarian clear cell carcinoma. Taiwan J Obstet Gynecol. 2015;54(5):625-628. doi:10.1016/j.tjog.2015.08.021

Devulapalli S, Pinto N, Gandothra C, Jayam-Trouth A, Kurukumbi M. A Rare Case of Occipital Stroke as a Consequence of Nonbacterial Thrombotic Endocarditis in Ovarian Clear Cell Carcinoma: A Case Report. Case Rep Neurol. 2012;4(1):84-91. doi:10.1159/000338811

Takano H, Nakajima K, Nagayoshi Y, et al. Clinical associations of Trousseau’s syndrome associated with cerebral infarction and ovarian cancer. J Gynecol Oncol. 2018;29(5). doi:10.3802/jgo.2018.29.e67

Kuan A-S, Teng C-J, Wu H-H, et al. Risk of ischemic stroke in patients with ovarian cancer: a nationwide population-based study. BMC Med. 2014;12(1):53. doi:10.1186/1741-7015-12-53

Nouh AM, Staff I, Finelli PF. Three Territory Sign. Neurol Clin Pract. 2019;9(2):124-128. doi:10.1212/CPJ.0000000000000603

Umemura T, Yamamoto J, Akiba D, Nishizawa S. Bilateral cerebral embolism as a characteristic feature of patients with Trousseau syndrome. J Clin Neurosci. 2017;42:155-159. doi:10.1016/j.jocn.2017.04.014

Chen W, He Y, Su Y. Multifocal cerebral infarction as the first manifestation of occult malignancy: Case series of trousseau’s syndrome and literature review. Brain Circ. 2018;4(2):65. doi:10.4103/bc.bc_1_18

Kuroda N, Hiramatsu H, Mori M, Tanaka T. Mechanical Thrombectomy for Trousseau Syndrome in a Terminally Ill Cancer Patient. J Pain Symptom Manage. 2019;57(3):688-694. doi:10.1016/j.jpainsymman.2018.12.327

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