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Stroke in malignancy: complexities of diagnosis and management: a case report
ConclusionsThis case highlights the importance of having a high threshold of suspicion for malignancy as a cause of stroke.
Source: Journal of Medical Case Reports - August 19, 2019 Category: General Medicine Source Type: research

Conveniently-Grasped Field Assessment Stroke Triage (CG-FAST): A Modified Scale to Detect Large Vessel Occlusion Stroke
Conclusions: CG-FAST scale could be an effective and simple scale for accurate identification of LVOS among AIS patients. Introduction Large vessel occlusion stroke (LVOS) often leads to severe disability and mortality. Although endovascular therapy (EVT) has been proved to be effective for LVOS patients (1–9), especially in anterior circulation, its benefit is highly time-dependent (10, 11). As hospitals with around-the-clock endovascular capability are scarce in many parts of the world and patients admitted directly to a CSC would have better outcomes than those receiving drip and ship treatment (12, 13), t...
Source: Frontiers in Neurology - April 16, 2019 Category: Neurology Source Type: research

Chemotherapy induced stroke mimic: 5-Fluorouracil encephalopathy fulfilling criteria for tissue plasminogen activator therapy
Stroke mimics, especially those involving chemotherapy related neurotoxicity, can confound the clinical diagnosis of acute stroke. Here we describe the case of a 63year-old male with a recent history of stage IIIC colon cancer who presented with confusion on the second day of modified FOLFOX6 (5-fluorouracil/oxaliplatin) chemotherapy and subsequently received alteplase, tissue plasminogen activator therapy (tPA), for presumed ischemic stroke. Magnetic resonance imaging scans after tPA administration did not reveal evidence of an infarction and the patients' neurological symptoms resolved completely after discontinuation of...
Source: The American Journal of Emergency Medicine - July 6, 2017 Category: Emergency Medicine Authors: May Thuy Nguyen, Robyn Stoianovici, Luigi Brunetti Source Type: research

Intravenous Thrombolysis in Acute Ischemic Stroke with Active Cancer.
In conclusion, ischemic stroke patients with active cancer, especially those with a cryptogenic mechanism, showed poor clinical outcomes after use of IV t-PA. PMID: 28660209 [PubMed - in process]
Source: Biomed Res - July 1, 2017 Category: Research Authors: Nam KW, Kim CK, Kim TJ, An SJ, Oh K, Ko SB, Yoon BW Tags: Biomed Res Int Source Type: research

The effect of 24 hour post-intravenous alteplase CT head on management decisions: a single center experience (S47.004)
Conclusion: For 95[percnt] of asymptomatic patients, a 24 hour post-alteplase CT head had no clinical impact. Antithrombotic treatment was delayed by asymptomatic hemorrhage in 2/3 of patients, depriving them of early antiplatelet therapy that reduces the risk of stroke within the first 14 days (Lancet. 349:1569-81). With an estimated 30,000 doses of alteplase given in US, cost of routine CT screening is significant at $6.6 million per year (Jt Comm J Qual Patient Saf. 41:313-22), and there is increased risk of cancer from radiation of 1/10000 (Arch Intern Med. 169:2078-86). Further studies are needed to determine if benef...
Source: Neurology - February 7, 2016 Category: Neurology Authors: Sevilis, T., Morantes Gomez, L., Shah, N., Wang, M., Huang, D., Powers, W. Tags: IV-tPA and Endovascular Therapy Source Type: research

Fatal Intracranial Hemorrhage after Intravenous Thrombolytic Therapy for Acute Ischemic Stroke Associated with Cancer-related Nonbacterial Thrombotic Endocarditis
Nonbacterial thrombotic endocarditis (NBTE) is associated with hypercoagulability in patients with inflammatory states such as cancer and autoimmune diseases. Cardiac vegetations caused by NBTE often lead to life-threatening systemic thromboembolism that most frequently affects the brain, spleen, and kidneys. A 54-year-old woman diagnosed with ovarian cancer suddenly developed back pain and left hemiparesis. Although intravenous alteplase (rt-PA) therapy was administered to treat hyperacute ischemic infarction detected by magnetic resonance imaging, intracranial hemorrhage occurred in the left hemisphere several hours late...
Source: Journal of Stroke and Cerebrovascular Diseases - August 11, 2014 Category: Neurology Authors: Takuya Yagi, Kie Takahashi, Mariko Tanikawa, Morinobu Seki, Takato Abe, Norihiro Suzuki Tags: Case Reports Source Type: research

Intravenous Alteplase for acute ischemic stroke in patients with current malignant neoplasm
Conclusions: Our experience suggests that IV thrombolysis does not appear to increase the risk of hemorrhagic complications in current non-metastatic cancer patients in absence of additional risk factors of bleeding. In addition, these patients showed clinical improvement after IV thrombolysis, although replication of our findings in a randomized controlled trial is required to confirm our results.
Source: Journal of the Neurological Sciences - January 14, 2013 Category: Neurology Authors: Manuel Cappellari, Monica Carletti, Nicola Micheletti, Giampaolo Tomelleri, Domenico Ajena, Giuseppe Moretto, Paolo Bovi Tags: Original Articles Source Type: research