Absence of susceptibility vessel sign and hyperdense vessel sign in patients with cancer-related stroke.

Beyeler, Morin; Grunder, Lorenz; Göcmen, Jayan; Steinauer, Fabienne; Belachew, Nebiyat F; Kielkopf, Moritz; Clénin, Leander; Mueller, Madlaine; Silimon, Norbert; Kurmann, Christoph; Meinel, Thomas; Bücke, Philipp; Seiffge, David Julian; Dobrocky, Tomas; Piechowiak, Eike I; Pilgram-Pastor, Sara; Mattle, Heinrich P; Navi, Babak B; Arnold, Marcel; Fischer, Urs; ... (2023). Absence of susceptibility vessel sign and hyperdense vessel sign in patients with cancer-related stroke. Frontiers in neurology, 14(1148152), p. 1148152. Frontiers Media S.A. 10.3389/fneur.2023.1148152

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Identification of paraneoplastic hypercoagulability in stroke patients helps to guide investigations and prevent stroke recurrence. A previous study demonstrated an association between the absence of the susceptibility vessel sign (SVS) on brain MRI and active cancer in patients treated with mechanical thrombectomy. The present study aimed to confirm this finding and assess an association between the absence of the hyperdense vessel sign (HVS) on head CT and active cancer in all stroke patients.


SVS and HVS status on baseline imaging were retrospectively assessed in all consecutive stroke patients treated at a comprehensive stroke center between 2015 and 2020. Active cancer, known at the time of stroke or diagnosed within 1 year after stroke (occult cancer), was identified. Adjusted odds ratios (aOR) and their 95% confidence interval (CI) for the association between the thrombus imaging characteristics and cancer were calculated using multivariable logistic regression.


Of the 2,256 patients with thrombus imaging characteristics available at baseline, 161 had an active cancer (7.1%), of which 36 were occult at the time of index stroke (1.6% of the total). The absence of SVS was associated with active cancer (aOR 3.14, 95% CI 1.45-6.80). No significance was reached for the subgroup of occult cancer (aOR 3.20, 95% CI 0.73-13.94). No association was found between the absence of HVS and active cancer (aOR 1.07, 95% CI 0.54-2.11).


The absence of SVS but not HVS could help to identify paraneoplastic hypercoagulability in stroke patients with active cancer and guide patient care.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Beyeler, Morin, Grunder, Lorenz Nicolas, Kielkopf, Moritz Christopher, Clénin, Leander Caspar, Müller, Madlaine, Silimon, Norbert, Kurmann, Christoph Carmelino, Meinel, Thomas Raphael, Bücke, Philipp Jonas, Seiffge, David Julian, Dobrocky, Tomas, Piechowiak, Eike Immo, Pilgram-Pastor, Sara Magdalena, Mattle, Heinrich, Arnold, Marcel, Fischer, Urs Martin, Pabst, Thomas Niklaus, Gralla, Jan, Berger, Martin Dave, Jung, Simon, Kaesmacher, Johannes


600 Technology > 610 Medicine & health




Frontiers Media S.A.




Pubmed Import

Date Deposited:

11 Apr 2023 09:15

Last Modified:

16 Apr 2023 02:19

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

cancer-related stroke hyperdense vessel sign malignancy-related stroke susceptibility vessel sign thrombus imaging characteristics





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