Cerebrovascular complications of cancer

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By Jai Grewal MD, Harpreet K Grewal MD, and Santosh Kesari MD PhD

Cerebrovascular disease (sinus thrombosis, cerebral infarction, or hemorrhage) is a common complication of cancer and of cancer therapy. In this clinical article, Drs. Jai Grewal, and Harpreet Grewal of the Movement Disorders Institute at the North Shore-LIJ Health System in Great Neck, New York and Santosh Kesari of the Moores UCSD Cancer Center in San Diego, California review the clinical milieu in which these disorders develop and summarize the methods of diagnosis, including characteristic abnormalities of clinical findings, coagulation function tests, and neuroimaging. The management of these vascular disorders can be challenging in this patient population because of comorbidities associated with cancer. Some vascular disorders are unique to the cancer patient, including radiation-induced carotid artery atherosclerosis and chemotherapy-induced vasculopathy. Until recently, reports of these latter conditions were anecdotal and infrequent. In recent years, large-scale studies have provided the first index of the frequency of these complications, particularly in lymphoma and breast cancer patients.