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A Case of Multiple Recurrent Ischemic Stroke in a Patient with Cholangiocarcinoma and Initiation of Anticoagulation Therapy for Secondary Stroke Prevention (P4.342)
CONCLUSIONS: Initiation of anticoagulation therapy and the optimal medications for secondary stroke prevention in cancer associated stroke remain controversial. Further randomized prospective studies are needed to establish treatment guidelines.Disclosure: Dr. Cheng has nothing to disclose. Dr. Then has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Cheng, J. Z., Then, R. Tags: Cerebrovascular Case Reports Source Type: research

Cryptogenic stroke
In about a quarter of ischaemic strokes the cause is undetermined, because the investigation is incomplete or delayed, because there are multiple causes or because the stroke is truly cryptogenic. Cryptogenic stroke can be further classified as non‐embolic or embolic. Embolic stroke of undetermined source can be due to paroxysmal atrial fibrillation, minor emboligenic cardiac conditions, atheroembolism, cancer associated and paradoxical embolism through a patent foramen ovale (PFO) or less often a pulmonary fistula. Currently, risk factor control, statins and antiplatelets are the main therapeutic measures to prevent rec...
Source: European Journal of Neurology - January 18, 2015 Category: Neurology Authors: A. C. Fonseca, J. M. Ferro Tags: Invited Review Source Type: research

Diagnostic dilemmas in a patient with multivascular embolic stroke.
We describe a patient admitted to the intensive care unit with aphasia, which was due to an embolic ischaemic cerebral stroke associated with a previously unknown patent foramen ovale. Eventually, this finding during echocardiography led us to the diagnosis of pancreatic cancer. The thrombotic complications of pancreatic cancer, in combination with a large, patent foramen ovale, support the mechanism of a paradoxical embolism through the patent foramen ovale as the cause of cerebral ischaemic stroke. PMID: 26031637 [PubMed - as supplied by publisher]
Source: Netherlands Heart Journal - June 2, 2015 Category: Cardiology Authors: Delsing CP, van Duijnhoven M, Arnoldussen C, le Noble J Tags: Neth Heart J Source Type: research

Endovascular aspiration to treat acute ischemic stroke caused by embolic carcinoma.
We report a rare case of large-cell, high-grade neuroendocrine lung cancer embolus occluding the basilar artery, which likely detached into the bloodstream from the lung after intruding into a pulmonary vein. The embolus was treated with endovascular aspiration, and achieved modified Thrombolysis In Cerebral Infarction 2c revascularization. After initial neurological recovery, the patient suffered respiratory arrest and support was withdrawn 48 h later. We discuss the tumor characteristics and implications for treatment of acute ischemic stroke in patients with cancer diagnoses. PMID: 30786802 [PubMed - as supplied by publisher]
Source: Interventional Neuroradiology - February 24, 2019 Category: Radiology Tags: Interv Neuroradiol Source Type: research

Ovarian Cancer Presenting as Cryptogenic Stroke from Patent Foramen Ovale.
Abstract A 52-year-old woman experienced severe headache, confusion, nausea, dizziness, and diplopia for three days. Magnetic resonance imaging of the brain showed multiple acute and subacute infarcts suggestive of embolic events. Dermatological examination was notable for splinter hemorrhages and macular patches on the fingernails and feet, respectively. Further diagnostic imaging of the chest and abdomen revealed pulmonary emboli and an ovarian mass with omental deposits and splenic infarcts. Fine needle aspiration cytology and surgery confirmed a diagnosis of high grade serous adenocarcinoma of the ovary with c...
Source: Clin Med Res - July 18, 2019 Category: Research Authors: Potugari BR, Priyanka P, Komanapalli SD, Mercier RJ Tags: Clin Med Res Source Type: research

Concomitant AngioVac thrombectomy and patent foramen ovale closure in a patient with a large right atrial thrombus and recent paradoxical embolic stroke.
Abstract A 59-year-old male with a history of gallbladder adenocarcinoma receiving chemotherapy and on therapeutic anticoagulation for portal vein thrombosis presented to the emergency department via ambulance after being found unresponsive and in cardiac arrest. Initial workup upon return of spontaneous circulation revealed a large right atrial mass, patent foramen ovale (PFO), and bilateral acute cortical infarctions. This constellation of findings were concerning for PFO-related paradoxical embolic strokes. Given the risk of recurrent paradoxical embolic events and the absolute contraindication to thrombolysis ...
Source: Diagnostic and Interventional Radiology : The Turkish Society of Radiology - February 18, 2021 Category: Radiology Authors: Callese TE, Yang EH, Levi D, Srinivasa RN, Moriarty JM Tags: Diagn Interv Radiol Source Type: research

From cryptogenic to ESUS: Toward precision medicine?
Rev Neurol (Paris). 2022 May 18:S0035-3787(22)00592-6. doi: 10.1016/j.neurol.2022.01.016. Online ahead of print.ABSTRACTCryptogenic infarctions are infarctions without a defined cause, despite a complete work-up. They differ from infarctions of undetermined causes, which may involve overlapping causes or an incomplete investigation. It is also different from uncommon heritable and non-heritable causes. The term embolic stroke of undetermined source (ESUS) proposed in 2014 is defined as a non-lacunar brain infarct without proximal arterial stenosis or cardioembolic sources. The major advantage of this definition compared to...
Source: Revue Neurologique - May 21, 2022 Category: Neurology Authors: S Timsit Source Type: research

Running out of brain.
We describe here two cases of young men suffering a stroke after running a marathon and who were subsequently found to have a patent foramen ovale (PFO). We have reviewed the existing literature concerning stroke in those undertaking long-distance running, and suggest why PFO may have been important etiologically in our two patients. We tentatively suggest that individuals with a PFO who engage in long distance running may be at increased risk of stroke, independent of other cerebrovascular risk factors. PMID: 24739301 [PubMed - in process]
Source: Medical Physics - April 20, 2014 Category: Physics Authors: Ganesalingam J, Jenkins IH, Vaughan J Tags: J Sports Med Phys Fitness Source Type: research

Concomitant AngioVac thrombectomy and patent foramen ovale closure in a patient with a large right atrial thrombus and recent paradoxical embolic stroke
Diagn Interv Radiol. 2021 Feb 18. doi: 10.5152/dir.2021.20291. Online ahead of print.ABSTRACTA 59-year-old male with a history of gallbladder adenocarcinoma receiving chemotherapy and on therapeutic anticoagulation for portal vein thrombosis presented to the emergency department via ambulance after being found unresponsive and in cardiac arrest. Initial workup upon return of spontaneous circulation revealed a large right atrial mass, patent foramen ovale (PFO), and bilateral acute cortical infarctions. This constellation of findings were concerning for PFO-related paradoxical embolic strokes. Given the risk of recurrent pa...
Source: Diagnostic and Interventional Radiology : The Turkish Society of Radiology - February 18, 2021 Category: Radiology Authors: Tyler E Callese Eric H Yang Daniel Levi Ravi N Srinivasa John M Moriarty Source Type: research

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