ABSTRACT
Stroke in the cancer patient is most often caused by disorders of coagulation that
are induced by the cancer, by cancer metastatic to the central nervous system, or
by coagulation disorders or vascular injury induced by cancer therapy. Nonbacterial
thrombotic endocarditis with diffuse thrombosis of cerebral vessels is often the cause
of cerebral infarction. Venous occlusion is most common in leukemic patients but can
also result from growth of solid tumor in the adjacent skull or dura. Chemotherapy
administration is associated with a small risk of cerebral arterial or venous thrombosis.
Radiation that is administered to the neck can result in delayed carotid atherosclerosis.
Tumor embolization to the brain is a rare cause of stroke. Fungal septic cerebral
emboli occur most commonly in leukemic patients who have undergone bone marrow transplant.
Hemorrhages occur in the brain parenchyma or subdural space and are most commonly
caused by acute disseminated intravascular coagulation or metastatic tumor. Hemolysis
from chemotherapy administration is a rare cause of brain hemorrhage. Neuroimaging
studies, measurement of coagulation function, and echocardiography are the must useful
modalities to identify the cause of stroke.
KEYWORDS
Coagulopathy - nonbacterial thrombotic endocarditis - disseminated intravascular coagulation
- venous occlusion
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