title: Histological Examination of Trousseau Syndrome-Related Thrombus Retrieved Through Acute Endovascular Thrombectomy: Report of 2 Cases.
abstract: The mechanism of thrombus formation in Trousseau syndrome remains unclear. The purpose of this study was to investigate specific pathological findings of the thrombi in Trousseau syndrome. The authors report on 2 cases of thrombi in Trousseau syndrome from large cerebral vessels removed by endovascular therapy and compared with thrombi in atherosclerosis or cardiac embolism. The first patient, a 67-year-old man, was transferred to our hospital for sudden onset consciousness disturbance and tetraparesis. He had been diagnosed with stage IV lung cancer. The magnetic resonance (MR) angiography demonstrated basilar artery occlusion. An endovascular thrombectomy was performed. The second patient, an 84-year-old woman, was transferred to our hospital for sudden onset motor aphasia and right-sided motor weakness. She has a history of stage IV pancreatic body cancer. The MR angiography demonstrated left middle cerebral artery occlusion. An endovascular thrombectomy was performed for the floating thrombus. Macroscopic findings of retrieved thrombi were observed immediately after thrombectomy. The thrombi in Trousseau syndrome were white in color and solid against manual compression, whereas thrombi from other causes were red and fragile. In terms of microscopic findings, the thrombi in Trousseau syndrome mainly contained fibrin. On the other hand, thrombi associated with atherosclerosis or cardiac embolism had smaller area of fibrin with a considerable amount of red and white blood cells. The thrombi in Trousseau syndrome, which caused occlusion of large cerebral vessel, almost exclusively consisted of fibrin.
authors.affiliation: Department of Neurosurgery, Kurashiki Central Hospital, Kyoto, Japan; Department of Neurosurgery, Kyoto University Hospital, Kyoto, Japan. Electronic address: naoki@kuhp.kyoto-u.ac.jp.
authors.forename: Naoki
authors.initials: N
authors.lastname: Matsumoto
authors.affiliation: Department of Neurosurgery, Kurashiki Central Hospital, Kyoto, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Fukuda
authors.affiliation: Department of Neurosurgery, Kurashiki Central Hospital, Kyoto, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Handa
authors.affiliation: Department of Neurosurgery, Kurashiki Central Hospital, Kyoto, Japan.
authors.forename: Toshinari
authors.initials: T
authors.lastname: Kawasaki
authors.affiliation: Department of Neurosurgery, Kurashiki Central Hospital, Kyoto, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Kurosaki
authors.affiliation: Department of Neurosurgery, Kurashiki Central Hospital, Kyoto, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Chin
authors.affiliation: Department of Neurosurgery, Kurashiki Central Hospital, Kyoto, Japan.
authors.forename: Sen
authors.initials: S
authors.lastname: Yamagata
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography / Q000379:methods; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D020766:Intracranial Embolism / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D020767:Intracranial Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D008175:Lung Neoplasms / Q000150:complications; D018810:Magnetic Resonance Angiography; D008297:Male; D010190:Pancreatic Neoplasms / Q000150:complications; D013577:Syndrome; D017131:Thrombectomy / Q000379:methods*; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology / Q000601:surgery*
keywords: Thrombus; Trousseau syndrome; acute cerebral large vessel occlusion; histological examination