Background Stroke is a clinical syndrome characterized by a sudden-onset neurological deficit of vascular cause. Stroke-like clinical symptoms that are later found to have nonvascular disorders have been termed stroke mimics (MIM), and their incidence ranges from 1.3 to 25% in patients not treated with thrombolytic therapy. Eventually, intravenous thrombolysis of MIM may occur.
Case Description We describe a 74-year-old woman with abrupt global aphasia who received thrombolytic therapy after the presumed diagnosis of acute ischemic stroke. She gradually improved despite the finding of an asymptomatic left temporal hematoma on the computed tomography (CT) scan. Two months later, she presented with a new focal neurological deficit and was diagnosed with a glioblastoma in the topography of the previous bleeding.
Conclusion This case highlights the rare occurrence of hemorrhage after thrombolysis in patients with MIM.
Background: Spinal cord compression is a common complication of spine metastasis and multiple myeloma. About 30% of patients with cancer develop symptomatic spinal metastases during their illness. Prompt diagnosis and surgical treatment of these lesions, although palliative, are likely to reduce the morbidity and improve quality of life by improving ambulatory function. Study Design: Retrospective review of medical records. Objective: To evaluate postoperative functional recovery and the epidemiological profile of neoplastic spinal cord compression in two neurosurgical centers in southern Brazil. Methods: We retrospectively analyzed the data of all patients who underwent palliative surgery for symptomatic neoplastic spine lesion from metastatic cancer, in two neurosurgical centers, between January 2003 and July 2021. The variables age, sex, neurological status, histological type, affected segment, complications and length of hospitalization were analyzed. Results: A total of 82 patients were included. The lesions occurred in the thoracic spine in 60 cases. At admission, 95% of the patients had neurological deficits, most of which were Frankel C (37%). At histopathological analysis, breast cancer was the most common primary site. After surgery, the neurological status of 46 patients (56%) was reclassified according to the Frankel scale. Of these, 22 (47%) regained ambulatory capacity. Conclusion: Surgical treatment of metastatic spinal cord compression improved neurological status and ambulatory ability in our sample. Level of evidence II; Retrospective study.
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