Endovascular aspiration to treat acute ischemic stroke caused by embolic carcinoma

Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences
James K GoddardLeslie A Nussbaum

Abstract

Although cardiac myxomas have been known to cause acute ischemic stroke and other cerebrovascular complications, intracranial embolization of metastatic tumor fragments is rare. This is likely because venous emboli generally cause pulmonary embolism. Pulmonary vein metastases and patent foramen ovales have previously shown to propagate intracranial embolic carcinomas, but these events are very uncommon, and are not well characterized. We report a rare case of large-cell, high-grade neuroendocrine lung cancer embolus occluding the basilar artery, which likely detached into the bloodstream from the lung after intruding into a pulmonary vein. The embolus was treated with endovascular aspiration, and achieved modified Thrombolysis In Cerebral Infarction 2c revascularization. After initial neurological recovery, the patient suffered respiratory arrest and support was withdrawn 48 h later. We discuss the tumor characteristics and implications for treatment of acute ischemic stroke in patients with cancer diagnoses.

References

Jan 8, 2005·Seminars in Neurology·Lisa R Rogers
Jul 28, 2009·Journal of Neurosurgery·Sanjay BhatiaAshis H Tayal
Feb 15, 2012·Archives of Neurology·Chan Soon KimChul-Ho Sohn
Sep 26, 2013·Stroke; a Journal of Cerebral Circulation·Santosh B MurthyJose I Suarez
Jun 13, 2015·Cerebrovascular Diseases·Waleed BrinjikjiChristopher P Wood
Oct 31, 2015·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Jung Hee ByonKyu Yun Jang

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Citations

Jun 4, 2020·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·F WolpertM Weller
Jul 23, 2020·NMC Case Report Journal·Takahiro OyamaTatsuo Takahashi
Mar 9, 2021·Internal Medicine·Kaoru NakanishiTeruyuki Hirano

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Methods Mentioned

BETA
biopsy

Software Mentioned

Telestroke

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