Basel • Freiburg • Paris • London • New York • Chennai • New Delhi • Bangkok • Beijing • Shanghai • Tokyo • Kuala Lumpur • Singapore • Sydney Founded 1897 as ‘Monatsschrift für Psychiatrie und Neurologie’, continued 1957–1967 as ‘Psychiatria et Neurologia’ Founders: C. Wernicke and Th. Ziehen. Successors: K. Bonhoeffer (1912–1938), J. Klaesi (1939–1967), E. Grünthal (1953–1967), H.E. Kaeser (1968–1993)

Background: The occurrence of acute ischemic stroke in cancer patients is not unusual. In clinical practice, acute ischemic stroke with cancer usually cannot be diagnosed promptly due to lack of specific markers. But for cancer patients, advanced prevention, accurate diagnosis and proper treatment of acute ischemic stroke are very important. The aim of the present study was to investigate the clinical and neuroimaging features of acute ischemic stroke in patients with cancer. Methods: We conducted a retrospective review of all cancer-associated acute ischemic stroke patients (n = 46) admitted to the Affiliated Hospital of Academy of Military Medical Sciences between October 2011 and March 2015. A group of non-cancer acute ischemic stroke patients (n = 50) at the same period were selected randomly as control. The clinical and neuroimaging data were collected and compared between the 2 groups. Results: Patients with cancer-associated stroke (CS) had a lower body mass index (23.26 ± 3.70 vs. 24.88 ± 2.83, p = 0.021) compared to non-cancer stroke (NC) patients. A lower proportion of CS patients suffered from hypertension (45.7 vs. 68.0%, p = 0.039) and hyperlipidemia (10.9 vs. 72.0%, p = 0.000) than the NC group. A higher proportion of CS patients had deep vein catheter (24.0 vs. 0%) before the onset of stoke than that of the NC group. Levels of hemoglobin, albumin and triglyceride were lower in CS groups compared with that of the NC group (p < 0.05). The prothrombin time, international normalized ratio, D-dimer and fibrinogen levels were significantly higher in the CS group than in the NC group (p < 0.05). As to the neuroimaging patterns, disperse lesions (OR 7.01; 95% CI 1.17-42.12; p < 0.05) was independently associated with CS. Conclusions: Cancer-associated ischemic stroke was different form conventional ischemic stroke in the aspect of clinical and neuroimaging manifestation. This phenomenon might be because of the embolic etiology of CS. These features together could become a clue to CS.

Objective: To evaluate the clinical characteristics and treatment of patients with non-nervous system malignancy related acute ischemic stroke. Methods: Thirty consecutive patients with non-nervous system malignancy and complicated with acute ischemic stroke at the Department of Neurology, the Affiliated Hospital of Academy of Military Medical Sciences from 2011 May to 2013 June were used as a malignant group. Thirty age- and sex-matched patients with acute ischemic stroke but without tumor were selected as the control group. The clinical data of both groups were collected and analyzed statistically. Results: Circled Digit OneComparing the traditional risk factors for stroke between the two groups, the percentage of hypertension in the malignant group was 40% (12/30), and it was less than 70.0% (21/30) in the control group. The percentage of the patients without high risk factors for stroke such as smoking history, drinking history, hypertension, coronary heart disease, and diabetes was 40% (12/30) in the malignant group, and it was higher than 13.3% (4/30) in control group. There was significant difference (P < 0.05). Circled Digit TwoLaboratory examination revealed that hemoglobin, platelet count, total cholesterol and low density lipoprotein cholesterol levels in the malignant group were lower than those in the control group (P < 0.05 or P < 0.01). The D-dimer levels were higher than those in the control group, they were 1.7 (0.10-6.67) and 0.45 (0.02-6.34) mg/L, respectively (P < 0.01). Circled Digit ThreeCerebral infarction lesions of 63.3% patients in the malignant group were bilateral hemispheric distribution, and 70.0% (21/30) in the control group were unilateral hemispheric distribution. There was significant difference (P < 0.01); 70% of the lesions in the control group were multiple lesions, while 63.3% of the lesions in the control group were single lesion (P < 0.01). Conclusion: The etiology of patients with malignancy-related acute cerebral infarction and non-malignancy-related ischemic stroke may be different. Blood hypercoagulability caused thrombosis may be one of the important causes.