Ischemic stroke in patients with primary brain tumors Journal Article
| Authors: | Kreisl, T. N.; Toothaker, T.; Karimi, S.; Deangelis, L. M. |
| Article Title: | Ischemic stroke in patients with primary brain tumors |
| Abstract: | Background: Primary brain tumor patients are at increased risk for stroke from disease and treatment-specific mechanisms. Methods: We conducted a retrospective review of patients with primary brain tumors diagnosed with MRI-confirmed ischemic stroke between 1996 and 2006. Data were collected including risk factors, diagnostic workup, and treatment for stroke. Modified Rankin Scale (MRS) scores at stroke diagnosis were determined, and stroke etiology was assigned using Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria for nonpostoperative strokes. Results: Sixty-eight cases of confirmed ischemic stroke in 66 patients (56% men) were analyzed. The median ageattime of stroke was 60years. The distribution of stroke risk factors was comparable to the general stroke population. The most common brain tumors were gliomas, 60%; me-ningiomas, 25%; and primary CNS lymphoma, 6%. Stroke was the initial clinical diagnosis in only 43% of cases. The distribution of stroke etiology was operative complication, 49%; cardioem-bolic, 12%; small vessel lacune, 12%; large vessel, 6%; other, 15%; and undetermined, 7%. Seventeen patients (25%) had strokes related to delayed effects of radiation. The median latency from radiation to stroke diagnosis was 3.2 years. Therapy for secondary prevention of stroke was added in one-half of patients. Median survival from the time of stroke was 1.7 years and was correlated with MRS scores. Conclusions: Treatment complications from surgery and radiotherapy account for the majority of ischemic strokes in patients with primary brain tumors. Stroke is often a missed diagnosis that can contribute additional neurologic disability in an already susceptible patient population. Copyright © by AAN Enterprises, Inc. |
| Keywords: | survival; adult; controlled study; aged; aged, 80 and over; middle aged; survival rate; retrospective studies; major clinical study; review; neuroimaging; nuclear magnetic resonance imaging; outcome assessment; brain tumor; glioma; neurosurgery; brain neoplasms; magnetic resonance imaging; disease association; radiotherapy; clinical assessment; risk factors; diagnostic approach route; pathology; retrospective study; risk factor; risk assessment; postoperative complication; stroke; scoring system; meningioma; brain ischemia; secondary prevention; cerebrovascular accident; rankin scale; neurosurgical procedures; brain lymphoma |
| Journal Title: | Neurology |
| Volume: | 70 |
| Issue: | 24 |
| ISSN: | 0028-3878 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2008-06-10 |
| Start Page: | 2314 |
| End Page: | 2320 |
| Language: | English |
| DOI: | 10.1212/01.wnl.0000314648.82924.6f |
| PUBMED: | 18541885 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 5" - "Export Date: 17 November 2011" - "CODEN: NEURA" - "Source: Scopus" |
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