Global Health Neurology Lab, Sydney, NSW 2000, Australia.
Neurovascular Imaging Laboratory, Clinical Sciences Stream, Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia.
Int J Mol Sci. 2023 Apr 28;24(9):7981. doi: 10.3390/ijms24097981.
The underlying aetiopathophysiology of cancer-related strokes and thromboembolisms differs from that of noncancer-related strokes, which makes treating cancer-related strokes and thromboembolisms a distinct clinical challenge. This necessitates the development of novel, individualised diagnostic and treatment strategies. However, limited guidelines are available for the management of cancer-related strokes and the prevention of acute strokes or other thromboembolic events in this patient population. In this article, we present an updated overview of the therapeutic and preventive strategies for strokes in cancer settings. These strategies include acute reperfusion therapy, anticoagulant therapy, antiplatelet therapy, and lifestyle management options. We also outline comprehensive pathways and highlight gaps in the evidence-based clinical management of cancer-related strokes or thromboembolisms. Additionally, future recommendations for the management of strokes in cancer patients are provided.
癌症相关卒中与血栓栓塞的潜在病因病理生理学不同于非癌症相关卒中,这使得治疗癌症相关卒中与血栓栓塞成为一个独特的临床挑战。这需要制定新的、个体化的诊断和治疗策略。然而,针对癌症相关卒中患者的卒中管理以及预防急性卒中和其他血栓栓塞事件的指南十分有限。在本文中,我们对癌症环境中的卒中治疗和预防策略进行了更新概述。这些策略包括急性再灌注治疗、抗凝治疗、抗血小板治疗和生活方式管理选择。我们还概述了综合途径,并强调了癌症相关卒中或血栓栓塞的循证临床管理中的空白。此外,还为癌症患者卒中的管理提供了未来建议。