Ischemic stroke in a patient with cholangiocarcinoma: a case study

Chaiyasit, Kamon; Wiwanitkit, Viroj

doi:10.1590/s0004-282x2012001000019

Cited by 1 publication

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“…1 27 34 In the literature, we only found one reported case of recurrent ischaemic stroke in the setting of cholangiocarcinoma. 35 Some studies found that the median time from diagnosis of underlying cancer to stroke was about 1 year, but in a number of patients with stroke could occur as early as 1 month or as late as several years after the cancer diagnosis. Interestingly, in some patients with stroke can be the initial sign of cancer, and approximately 84% of such patients had a second stroke within the following 4 months.…”

Section: Discussionmentioning

confidence: 99%

Multiple recurrent ischaemic strokes in a patient with cancer: is there a role for the initiation of anticoagulation therapy for secondary stroke prevention?

2017

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A 52-year-old woman with a medical history of cervical and thyroid cancer, hypertension, dyslipidaemia, uncontrolled diabetes and heavy smoking was diagnosed with a new metastatic cholangiocarcinoma. While undergoing palliative chemotherapy, she developed dysarthria and left-sided weakness. Imaging studies showed multiple bilateral ischaemic strokes. On hospital days 2 and 5, she developed worsening neurological symptoms and imaging studies revealed new areas of ischaemia on respective days. Subsequent workup did not revealed a clear aetiology for the multiple ischaemic events and hypercoagulability studies were only significant for a mildly elevated serum D-dimer level. Although guidelines are unclear, full-dose anticoagulation with low molecular weight heparin was initiated given her high risk of stroke recurrence. She was discharged to acute rehabilitation but, within a month, she experienced complications of her malignant disease progression and a new pulmonary thromboembolism. The patient died soon after being discharged home with hospice care.

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Section: Discussionmentioning

confidence: 99%