Title:Does Diffusion Restriction Pattern on MRI Predict Stroke Etiology in a
Cancer Patient?
Volume: 19
Author(s): Mehmet Kolukisa, Bahar Aksay Koyuncu, Alişan Bayrakoglu and Talip Asil*
Affiliation:
- Department of Neurology, Memorial
Hizmet Hospital, Istanbul, Turkey
Keywords:
Ischemic stroke, etiology, cancer, diffusion MRI, DWI, HT.
Abstract:
Background: Stroke and cancer are two of the most common health problems. Moreover,
stroke is more common in patients with cancer than in the normal population, due to coagulation problems.
Knowing the etiology of stroke is important for determining treatment options. This study aimed
to determine the relationship between ischemic lesion topographies using diffusion-weighted magnetic
resonance imaging (MRI) and the etiology of stroke in patients with cancer.
Patients and Methods: All patients with ischemic stroke in the Bezmialem Stroke Registry over a 4-
year period were retrospectively analyzed in this study. Patients with acute ischemic stroke and additional
diagnoses of solid and active malignancy (excluding hematologic malignancies) were included
in the analysis. We investigated whether there was a relationship between the etiology of patients with
cancer-related stroke according to the stroke etiologic classification and the diffusion restriction patterns
on MRI.
Results: In this registry, 32 of 1472 patients were diagnosed as having active cancer. Fourteen patients
were evaluated as having definite cardioembolism, eight patients as probable cardioembolism, and four
patients had inadequate examinations. Only one patient was classified as having an atherothrombotic
stroke. Isolated acute infarction was seen in 15 of 32 patients. In patients with multiple acute infarct
areas (n=17), acute lesions characterized by micro embolisms in a single vessel area were detected in
four patients, and acute lesions characterized by bilateral (anterior and/or posterior system) micro embolisms
in more than one vessel area in 13 patients.
Conclusion: The most common etiology of stroke in patients with cancer was found to be embolic/
cardioembolic. This is important for the treatment plans for ischemic stroke in patients with cancer.