Cerebrovascular complications in cancer patients.

Cerebrovascular disorders often complicate the clinical course of a variety of solid tumors and hematologic/lymphoreticular malignancies. In rare instances, cerebrovascular disease is the presenting sign of cancer. Cerebral hemorrhages are more common in leukemia, and infarctions are more common in lymphoma and solid tumors. The usual causes of stroke are the direct effects of tumor in the brain or adjacent structures, coagulation disorders, infection, or toxicity of antineoplastic therapy. The type of systemic cancer, the extent of systemic and central nervous system metastasis, and the type of antineoplastic treatment are the most important clues in determining the etiology of cerebrovascular disease in cancer patients. Neuroimaging studies often assist in diagnosis and disease localization. Coagulation function tests are most useful in identifying coagulopathies associated with hemorrhage.