急性双侧前后循环脑梗死与恶性肿瘤

Association Correlation between acute bilateral anterior-posterior circulation infarct and malignant tumor

目的通过对表现为急性脑梗死且双侧、前后循环均受累的Trousseau综合征的分析,探讨其与恶性肿瘤的关系。方法收集并分析首发表现为急性双侧前后循环脑梗死的Trousseau综合征3例,并进行相关文献复习。结果 3例均以单纯急性脑卒中起病,头部MRI显示为急性双侧前后循环脑梗死,伴凝血功能异常和肿瘤标记物增高。肿瘤诊断分别为胆管细胞癌、肺癌和乳腺癌。结论本研究首次报道了表现为急性双侧前后循环脑梗死的Trousseau综合征。结合影像学和实验室检查,推测3例脑梗死的形成主要与肿瘤造成的高凝状态有关。当老年患者以急性卒中起病,影像学检查提示特征性的急性双侧前后循环脑梗死时,要高度警惕存在恶性肿瘤的可能。

Objective To investigate association between Trousseau＇ s syndrome with acute bilateral anterior-poste- rior circulation infarct and malignant tumor. Methods We collected the clinical data of 3 cases diagnosed as Trousseau＇ s syndrome in which the first symptom was acute cerebral infarct with bilateral anterior-posterior circulation involved. The ca- ses were analyzed and discussed with literature reviewed. Results The 3 cases began as simple acute stroke with coagula- tion disorder and abnormal tumor markers. MR showed acute bilateral anterior-posterior circulation infarct. Cholangiocellu- lar carcinoma,lung cancer and breast cancer were detected respectively. Conclusion Our study first reports Trousseau＇ s syndrome with acute bilateral anterior-posterior circulation infarct. It is possible that cerebral infarct was related to hyperco- agulability tumor induced. Examinations should be performed to search tumor when stroke happened in aged patients and neuroimaging showed characteristic acute bilateral anterior-posterior circulation infarct.