title: Clinical presentation and ischemic zone on MRI in cancer patients with acute ischemic stroke.
abstract: OBJECTIVE
  This study was conducted to evaluate the clinical and MRI profiles in acute cancer strokes, and to demonstrate our experience with thrombolytic therapy in cancer stroke patients.
  
  
  METHODS
  We prospectively studied active cancer patients with acute ischemic stroke who underwent MRI within 48 h of the onset of symptoms. Patients were grouped based on the presence of conventional stroke mechanisms (CSM). Clinical characteristics and MRI profiles were evaluated.
  
  
  RESULTS
  A total of 70 patients were finally included in this study. Patients without CSM were more frequently presented with encephalopathy than those with CSM (29.4 vs. 2.8%, p = 0.002). The diffusion-perfusion mismatch pattern was more prevalent in patients with CSM (21 patients, 58.3%) than in patients without CSM (8 patients, 23.5%). Patients who had a higher tertiles of D-dimer level were significantly less likely to have the diffusion-perfusion mismatch pattern (p = 0.015). Among patients who presented within 6 h of the onset of stroke, revascularization therapy was performed in 4 of 16 (25%) patients with CSM, but none of the patients without CSM.
  
  
  CONCLUSIONS
  Based on the stroke mechanisms, the optimal strategy of thrombolytic therapy should be considered differently in cancer patients with acute ischemic stroke.
authors.affiliation: Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jin Myoung
authors.initials: JM
authors.lastname: Seok
authors.forename: Suk Jae
authors.initials: SJ
authors.lastname: Kim
authors.forename: Pamela
authors.initials: P
authors.lastname: Song
authors.forename: Chin-Sang
authors.initials: CS
authors.lastname: Chung
authors.forename: Gyeong-Moon
authors.initials: GM
authors.lastname: Kim
authors.forename: Kwang Ho
authors.initials: KH
authors.lastname: Lee
authors.forename: Oh Young
authors.initials: OY
authors.lastname: Bang
mesh_terms: D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D002560:Cerebrovascular Circulation / Q000187:drug effects / Q000502:physiology; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000379:methods