[Gastric adenocarcinoma complicated by subarachnoid hemorrhage and cerebral infarction: a rare case of Trousseau syndrome and literature review].

Abstract

Trousseau's syndrome is a thromboembolic disorder associated with malignancies, with cerebral infarction and hemorrhage representing common central nervous system complications in patients with cancer. This report details the diagnosis and treatment of a patient with gastric adenocarcinoma at our institution who concurrently developed cerebral infarction and subarachnoid hemorrhage. We performed a comprehensive literature review in the Wanfang and PubMed databases, searching for relevant studies on Trousseau's syndrome, cerebral embolism, and subarachnoid hemorrhage. A total of 42 patients (23 male and 19 female) with complete clinical data were included, including the present case.Our analysis showed that these patients had 10 different types of tumors, with lung cancer, gastric cancer, and ovarian cancer being the most prevalent. D-dimer levels were elevated in 38 cases, and 38 patients exhibited cerebral infarction affecting three or more vascular territories. Anticoagulant therapy was administered to 40 patients, 22 experienced a recurrence of cerebral infarction within a short timeframe, and 28 died within one year. Cases of Trousseau's syndrome associated with subarachnoid hemorrhage are rare and, to our knowledge, have not been previously reported in the literature. Patients experiencing strokes due to Trousseau's syndrome tend to have poor prognoses. However, targeted antitumor therapy in conjunction with anticoagulation may effectively reduce the risk of stroke recurrence and enhance patient outcomes.