Suitability of Thrombolysis for Patients With Acute Ischemic Stroke Complicated With Trousseau Syndrome

Frontiers in Neuroscience

Ziyang Geng¹  Shiguang Zhu¹  Xin Wang¹  Yan Liu¹  Chenchen Ma¹  Yujie Chen¹  Ruiguo Dong¹  Chundi Zhang¹  Rui Wang¹  Long Han² 

[1] Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China;Department of Orthopedics, The Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, Changzhou, China;

关键词: Trousseau syndrome;    acute ischemic stroke;    rtPA intravenous thrombolysis;    cerebral hemorrhage after thrombolysis;    recurrence;   

DOI  :  10.3389/fnins.2020.00481

来源: DOAJ

【 摘 要 】

Intravenous thrombolysis (IVT) improves functional outcome after acute ischemic stroke (AIS) and is the standard first-line treatment; however, it is associated with many complications, including cerebral hemorrhage. Cancer patients are susceptible to thrombotic events – collectively referred to as Trousseau syndrome (TS) – owing to their hypercoagulable state. Here, we describe the case of a 55-year-old male with a history of hypertension for over 10 years who underwent surgery for removal of a cancer of lower esophagus, with no subsequent treatment. Three months later, he was admitted to the emergency department of our hospital with sudden dizziness and incoherent speech. Brain computed tomography revealed multiple cerebral infarctions. The patient was treated by IVT with tissue plasminogen activator (rtPA) after the onset of symptoms, which improved by the end of the treatment. However, a few months later, he experienced a recurrence of cerebral infarction and hemorrhage, which has rarely been reported. The clinical course of this case suggests that the suitability of thrombolysis with rtPA in the acute phase of cerebral infarction complicated with TS should be carefully considered.

【 授权许可】

Unknown