Carotid free-floating thrombus in patients with acute ischaemic stroke and active cancer.
Pract Neurol
; 24(4): 316-319, 2024 Jul 16.
Article
em En
| MEDLINE
| ID: mdl-38575305
ABSTRACT
In patients with ischaemic stroke, a carotid free-floating thrombus (CFFT) raises diagnostic and therapeutic challenges. We describe two women, each taking tamoxifen for invasive non-metastatic breast cancer, who developed large-vessel occlusion ischaemic strokes. The first had a CFFT 24 hours after receiving intravenous thrombolysis and mechanical thrombectomy; the thrombus completely resolved after 1 week of therapeutic anticoagulation. The second had a tandem occlusion with a CFFT at admission; her neurological deficits rapidly improved after intravenous thrombolysis without needing a mechanical thrombectomy. However, subsequently, under therapeutic anticoagulation, distal migration of the CFFT caused a recurrent large vessel occlusion ischaemic stroke, requiring mechanical thrombectomy. The CTFF in both cases appeared to relate to a cancer-related prothrombotic state. Both received long-term oral anticoagulation and their tamoxifen was switched to anastrozole. At 3 months, both were functionally independent without recurrent vascular events.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Mama
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AVC Isquêmico
Limite:
Aged
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Female
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Humans
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Middle aged
Idioma:
En
Revista:
Pract Neurol
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Portugal