Cerebral embolism in nonbacterial thrombotic endocarditis associated with carcinoma. A clinico-pathological study.
The clinical and pathological features of 24 patients with cerebral emboli complicating 66% of our cases of nonbacterial thrombotic endocarditis (NBTE) associated with carcinoma are reviewed. Twelve patients were admitted for a cerebrovascular accident (CVA) while 4 patients developed a CVA during hospitalization. Transient ischemic attacks preceded the CVA in 3 patients. More often the CVA took the form of a single sudden accident. Cerebral infarcts however were generally multiple and hemorrhagic and varied in size and age. In 4 patients large softenings were directly responsible for death. 8.6% of cerebral embolisms were caused by NBTE and in 10 patients cerebral embolization was the first symptom of a carcinoma. The frequency of NBTE in ovarian carcinoma even in the absence of metastases may motivate a more aggressive approach towards unexplained cerebral embolism.
D002288:Adenocarcinoma, Mucinous / Q000150:complications* / Q000473:pathology; D000368:Aged; D004696:Endocarditis / Q000150:complications* / Q000473:pathology; D005260:Female; D005706:Gallbladder Neoplasms / Q000150:complications* / Q000473:pathology; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged