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Diagnosis of cancer was most often made within 12 months preceding (32.4%) or during the diagnostic work-up for stroke (17.7%). Cancer-associated stroke was characterized by a more severe clinical deficit, frequent clinical deterioration (13.2 vs 1.5%) or death (25 vs 4.4%). Ischemic lesions often involved multiple territories (51.6 vs 12.7%), more often with co-existing subacute and acute infarctions in imaging studies (54.8 vs 11.1%). Patients with cancer had significantly higher levels of C-reactive protein, relative granulocytosis and serum lactate dehydrogenase activity. Using receiver operating characteristics-based multiple analysis, we developed a model using these parameters which detected cancer-associated stroke with a sensitivity of 75% and specificity of 95%. Our analysis suggests that a multiple algorithm combining the number of territories involved and laboratory signs of inflammation and cell turnover might identify patients with stroke suffering from previously unknown malignancy. |
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algorithm cancer,cerebrovascular accident complicating patients with carcinoma cerebrovascular accident cerebrovascular accident,multiple cerebrovascular accident,three territory involvement C-reactive protein C-reactive protein,elevated heralding manifestation lactic dehydrogenase(LDH) MRI,abnormal neurologic complications of,systemic cancer
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