J Neurocrit Care.  2020 Dec;13(2):123-127. 10.18700/jnc.200012.

Multiple embolic infarctions and intracranial hemorrhage in a patient with gestational trophoblastic disease

• Kim KY
• Jung S
• Yoon C
• Jeong H
• Cho EB
• Yang TW
• Kim SJ
• Hwang S
• Park KJ

• KMID: 2509944
• DOI: http://doi.org/10.18700/jnc.200012

Abstract

Background
Choriocarcinoma is a subtype of gestational trophoblastic disease (GTD) that can spread to multiple organs, including the central nervous system. Most cases of GTD affecting the central nervous system can cause intra- or extra-axial hemorrhages.
Case Report
Herein, we describe a rare case of multiple embolic infarctions and intracranial hemorrhages in a patient with GTD.
Conclusion
The precise pathogenesis of the coexistence of multiple embolic infarctions and intracranial hemorrhage remains unclear. Cancer-related coagulopathy, micro-tumor emboli, or both could be involved in the pathogenesis of the rare presentation of this patient.

Keyword

Gestational trophoblastic disease; Stroke; Intracranial hemorrhage

Figure

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  Fig. 1. Initial brain magnetic resonance imaging shows multiple embolic infarctions in the multiple vascular territories (A-E). Intracerebral hemorrhage in the left occipital lobe and adjacent intraventricular, subdural and subarachnoid hemorrhages are also observed on susceptibility-weighted images (F-I). No significant vascular derangement is seen on the magnetic resonance angiography (J).

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  Fig. 2. Axial (A, B) and coronal (C, D) views of the chest computed tomography show clustered nodular and tubular opacities, as well as tree-in-bud appearances in both the lungs.

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