The activity of malignancy may determine stroke pattern in cancer patients.

BACKGROUND: It has been suggested that stroke in patients with cancer may differ from the conventional pattern. The aim of this study was to evaluate the burden of vascular risk factors, stroke etiology, and short-term outcome in patients with active and nonactive malignancy compared with patients without cancer. METHODS: This is a prospective cohort study of consecutive acute stroke patients admitted to our department between September 2006 and September 2011. We distinguished between the following: (1) patients with active malignancy (AM, diagnosed not earlier than 12 months before stroke); (2) patients with nonactive malignancy (non-AM); and (3) cancer-free (CF) patients, used as a reference. RESULTS: Pre-existing cancer was found in 90 of 1558 patients, including 41 (2.6%) cases with AM and 49 (3.1%) cases with non-AM. Compared with CF patients, AM patients less frequently had a history of previous stroke (2.4% versus 17.9%, P = .018) and more frequently experienced ischemic strokes of undetermined etiology (62.5% versus 38.3%, P = .002). Non-AM patients did not differ in the distribution of vascular risk factors but more often experienced stroke caused by small vessel occlusion (20.0% versus 8.0%, P = .004). Inflammatory blood markers were elevated especially in patients with AM. Short-term prognosis was similar across all groups. CONCLUSIONS: Stroke pattern in patients with non-AM appears very similar to that observed in the CF patients. However, our findings support the thesis that cancer-specific prothrombotic mechanisms play an important role in stroke patients with AM, which may be related to active inflammatory and immune processes. Malignancy does not influence short-term prognosis of stroke.

Positivity of serum "classical" onconeural antibodies in a series of 2063 consecutive patients with suspicion of paraneoplastic neurological syndrome.

This study determined the prevalence of classical onconeural Ab in a series of 2063 consecutive patients that were investigated because of suspicion of PNS as well as evaluated individual onconeural Ab in relationship to the clinical spectrum of associated neurological syndromes and tumor types detected in 70 patients finally diagnosed with PNS. We conclude that detectability of onconeural Ab is low among patients suspected with PNS. Specification of Ab is helpful in defining a neurological syndrome as paraneoplastic as well as in searching of underlying tumor. The success in tumor screening depends on the type of onconeural Ab.