[Cerebrovascular disease in the cancer patient]

Abstract

Objective: To make an up-to-date review of the literature on cerebrovascular disease of the patient with cancer.

Development: Approximately 15% of the patients with cancer have cerebrovascular disease. The frequency of cerebral infarcts is similar to that of cerebral hemorrhage. The commonest mechanisms of cerebral ischemia are atherosclerosis, non-bacterial thrombotic endocarditis, disseminated intravascular coagulation, infection, tumour embolism and thrombosis of the longitudinal venous sinuses. The most usual mechanisms of cerebral hemorrhage are intratumoural hemorrhage, hypertensive hemorrhage and the coagulopathies. In the Stroke Register of the Hospital del Sagrat Cor in Barcelona, of a total of 1,099 patients with their first cerebrovascular episode, in 14 patients the stroke (12 infarcts and two intracerebral hemorrhages) were the form of onset of a previously unrecognised hematological disorder. The hematological neoplasias were the commonest form of hematological disorders, mainly essential thrombocythemia, which was diagnosed in six patients.

Conclusions: The clinical management and care of patients with stroke and cancer differ from that of patients with stroke alone, since the cause is different from that of non-neoplastic patients.