当前位置: X-MOL 学术Int. J. Stroke › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
D-dimer in ischemic stroke, and insights from HEADPOST into swallowing problems and outcome after stroke.
International Journal of Stroke ( IF 6.7 ) Pub Date : 2020-02-25 , DOI: 10.1177/1747493020906727
Hugh S Markus 1
Affiliation  

All stroke clinicians come across difficult diagnostic challenges, which provide useful learning. One recent case that challenged me was a woman in her 50 s with recurrent embolic looking strokes but no obvious cause. An elevated D-dimer proved a key diagnostic clue, resulting in a close search for malignancy and the discovery of a uterine malignancy. Fortunately, this was benign and since the tumor’s excision, D-dimer has fallen and she has remained symptom free. The potential utility of D-dimer in stroke care is reviewed in this journal by Ohara et al.1 They describe how D-dimer may be elevated in certain subtypes of stroke, for example cardioembolic versus lacunar stroke, but sensibly point out that other diagnostic methods, such as brain imaging, mean that its contribution here is limited. However, they highlight its particular use in detecting occult cancer. While one in 10 patients with ischemic stroke have co-morbid cancer,2 occult cancer being causally related to stroke is much rarer, although an important diagnosis not to miss. An elevated D-dimer may be a useful test in detecting such cases.

中文翻译:

缺血性卒中的D-二聚体,以及HEADPOST对卒中后吞咽问题和结局的见解。

所有中风临床医生都遇到了困难的诊断挑战,这些挑战提供了有益的学习机会。最近的一个挑战我的案例是一名五十多岁的妇女,她反复出现栓子样中风,但无明显原因。升高的D-二聚体被证明是关键的诊断线索,从而导致对恶性肿瘤的密切搜索和子宫恶性肿瘤的发现。幸运的是,这是良性的,并且自切除肿瘤以来,D-二聚体已经下降,并且她没有任何症状。Ohara等人在该杂志中回顾了D-二聚体在中风护理中的潜在效用。1个他们描述了D-二聚体在某些中风亚型中可能如何升高,例如心脏栓塞性与腔隙性中风,但明智地指出,其他诊断方法(例如脑成像)意味着其在此处的作用是有限的。但是,它们强调了其在检测隐匿性癌症中的特殊用途。尽管每10名缺血性中风患者中就有1名患有合并症,但与中风因果相关的隐匿性癌症却少得多,尽管重要的诊断方法不可错过。升高的D-二聚体可能是检测此类情况的有用测试。
更新日期:2020-04-20
down
wechat
bug