Cancer and stroke : commonly encountered by clinicians, but little evidence to guide clinical approach

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Woock , M , Martinez-Majander , N , Seiffge , D J , Selvik , H A , Nordanstig , A , Redfors , P , Lindgren , E , Sanchez van Kammen , M , Rentzos , A , Coutinho , J M , Doyle , K , Naess , H , Putaala , J , Jood , K & Tatlisumak , T 2022 , ' Cancer and stroke : commonly encountered by clinicians, but little evidence to guide clinical approach ' , Therapeutic advances in neurological disorders , vol. 15 , 17562864221106362 . https://doi.org/10.1177/17562864221106362

Title: Cancer and stroke : commonly encountered by clinicians, but little evidence to guide clinical approach
Author: Woock, Malin; Martinez-Majander, Nicolas; Seiffge, David J.; Selvik, Henriette Aurora; Nordanstig, Annika; Redfors, Petra; Lindgren, Erik; Sanchez van Kammen, Mayte; Rentzos, Alexandros; Coutinho, Jonathan M.; Doyle, Karen; Naess, Halvor; Putaala, Jukka; Jood, Katarina; Tatlisumak, Turgut
Contributor organization: HUS Neurocenter
Neurologian yksikkö
Clinicum
Department of Neurosciences
University of Helsinki
Date: 2022-06
Language: eng
Number of pages: 18
Belongs to series: Therapeutic advances in neurological disorders
ISSN: 1756-2856
DOI: https://doi.org/10.1177/17562864221106362
URI: http://hdl.handle.net/10138/346400
Abstract: The association between stroke and cancer is well-established. Because of an aging population and longer survival rates, the frequency of synchronous stroke and cancer will become even more common. Different pathophysiologic mechanisms have been proposed how cancer or cancer treatment directly or via coagulation disturbances can mediate stroke. Increased serum levels of D-dimer, fibrin degradation products, and CRP are more often seen in stroke with concomitant cancer, and the clot retrieved during thrombectomy has a more fibrin- and platelet-rich constitution compared with that of atherosclerotic etiology. Multiple infarctions are more common in patients with active cancer compared with those without a cancer diagnosis. New MRI techniques may help in detecting typical patterns seen in the presence of a concomitant cancer. In ischemic stroke patients, a newly published cancer probability score can help clinicians in their decision-making when to suspect an underlying malignancy in a stroke patient and to start cancer-screening studies. Treating stroke patients with synchronous cancer can be a delicate matter. Limited evidence suggests that administration of intravenous thrombolysis appears safe in non-axial intracranial and non-metastatic cancer patients. Endovascular thrombectomy is probably rather safe in these patients, but probably futile in most patients placed on palliative care due to their advanced disease. In this topical review, we discuss the epidemiology, pathophysiology, and prognosis of ischemic and hemorrhagic strokes as well as cerebral venous thrombosis and concomitant cancer. We further summarize the current evidence on acute management and secondary preventive therapy.
Subject: cancer
cerebral venous thrombosis
clot
diagnostics
hemorrhagic stroke
intracerebral hemorrhage
ischemic stroke
risk
stroke
therapy
CEREBRAL VENOUS THROMBOSIS
ACUTE ISCHEMIC-STROKE
D-DIMER
INTRACRANIAL HEMORRHAGE
THROMBOEMBOLIC DISEASE
ORGANIZATION GUIDELINE
CRYPTOGENIC STROKE
EUROPEAN ACADEMY
SINUS THROMBOSIS
RECURRENT STROKE
3112 Neurosciences
3124 Neurology and psychiatry
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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