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Cerebrovascular Complications of Cancer

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Cancer Neurology In Clinical Practice

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Summary

A wide variety of cerebrovascular disorders can complicate the clinical course of cancer patients and, in rare instances, be the presenting sign of cancer. Central nervous system (CNS) hemorrhagic or ischemic events are typically symptomatic. Hemorrhage can occur into the parenchymal, subdural, epidural, or subarachnoid compartments. Cerebral infarction may cause focal signs presenting as a transient ischemic attack or as a completed infarction, or encephalopathy secondary to multiple small infarctions. The most common mechanisms of cerebrovascular disease in the cancer patient are the presence of CNS tumor or coagulopathy. The coagulopathy is a direct effect of the neoplasm in many cases; in other cases it develops from cancer treatment, most commonly chemotherapy. Radiation therapy to extracranial or cranial sites can also result in vessel stenosis or thrombosis. It is important to identify cerebrovascular disease as the cause of neurologic symptoms in the cancer patient. Laboratory studies of coagulation function and CNS imaging techniques are useful in identifying the precise etiology of the cerebrovascular disorder. Prompt diagnosis leads to appropriate therapy, which in many patients can improve the clinical neurologic condition as well as prevent additional vascular episodes.

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Authors
  1. Lisa R. Rogers DO
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  2. Megan C. Leary MD
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  3. Jeffrey L Saver MD
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Editor information

Editors and Affiliations

  1. School of Medicine, University of Virginia, Charlottesville, VA

    David Schiff MD

  2. Center for Neuro-Oncology Dana-Farber/Brigham and Women’s Cancer Center and Department of Neurology, Brigham and Women’s Hospital, Boston, MA

    Santosh Kesari MD, PhD  & Patrick Y. Wen MD  & 

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Rogers, L.R., Leary, M.C., Saver, J.L. (2008). Cerebrovascular Complications of Cancer. In: Schiff, D., Kesari, S., Wen, P.Y. (eds) Cancer Neurology In Clinical Practice. Humana Press. https://doi.org/10.1007/978-1-59745-412-4_14

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