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50 - CANCER AND PARANEOPLASTIC STROKES

from PART V: - SYSTEMIC DISORDERS THAT ALSO INVOLVE THE CEREBROVASCULAR SYSTEM

Published online by Cambridge University Press:  06 January 2010

By
Rogelio Leira ,
Antonio Dávalos  and
José Castillo
Edited by
Louis R. Caplan  and
Julien Bogousslavsky
Louis R. Caplan
Affiliation:
Beth Israel Deaconess Medical Center, Boston
Julien Bogousslavsky
Affiliation:
Valmont Clinique, Glion, Switzerland
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Summary

Paraneoplastic strokes show a clinical picture different from those observed in stroke patients without cancer. Diffuse and progressive encephalopathy, either isolated or accompanied by focal neurological manifestations, is usual in disseminated intravascular coagulation, nonbacterial thrombotic endocarditis, and paraneoplastic vasculitis. The clinical presentation of paraneoplastic cerebral venous thrombosis includes severe, diffuse, and progressive headache due to intracranial hypertension, partial or generalized seizures, transient ischemia or cerebral infarct of venous origin, and progressive ischemic encephalopathy. The diagnostic process for paraneoplastic strokes is different from standard procedures for other types of stroke. Cerebral computed tomography (CT) and magnetic resonance imaging (MRI) can be normal in ischemic events caused by disseminated intravascular coagulation, or may show multiple images in several vascular territories in nonbacterial thrombotic endocarditis and vasculitis. Heparin may be effective in preventing cerebral infarction among patients with nonbacterial thrombotic endocarditis and does not increase the risk of hemorrhagic complications.

Keywords

bleeding disordersblood transfusion therapycerebral venous sinus thrombosisHeparin-induced thrombocytopeniasickle cell diseasemyeloproliferative diseasesischemic strokeintracerebral hemorrhagethrombophiliatransient ischemic attack
Type
Chapter
Information
Uncommon Causes of Stroke , pp. 371 - 376
Publisher: Cambridge University Press
Print publication year: 2008

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