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Side Effect: Stroke (thrombotic and hemorrhagic)

What is a Stroke?

A stroke is a medical emergency that occurs when blood flow to a part of the brain is interrupted, leading to brain cell damage or death.
Strokes are usually caused by either:

What does a Stroke look like?

The symptoms of a stroke can vary depending on which part of the brain is affected, but they often include:

Stroke (thrombotic and hemorrhagic)


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A stroke can be the result of a blood clot causing reduced blood flow to part of the brain (thrombotic or ischemic stroke), or from bleeding into the brain (hemorrhagic stroke) which creates increased pressure within the brain.

Who gets a Stroke?

Patients with cancer have an increased risk of developing a blood clot, known as a thrombotic event. Blood clots may include those in the legs or lungs, but if a blood clot travels from these areas to the brain, it may cause a stroke. Some patients with cancer develop blood clots more easily due to the cancer itself, or due to certain types of chemotherapy. When someone develops blood clots more easily, this is often referred to as having a hypercoagulable state.

This risk of having a stroke may be further increased in patients with other risk factors such as:

Certain cancer treatments can increase risk of stroke such as:

Patients with cancer can also have an increased risk of hemorrhagic stroke, particularly those with:

How to prevent Stroke (thrombotic and hemorrhagic)

Controlling blood pressure, stopping smoking, and maintaining adequate physical activity can help reduce the risk of thrombotic stroke (blood clot in the brain).

Prevention of hemorrhagic stroke (bleeding in the brain) in patients with cancer involves managing underlying risk factors such as high blood pressure and avoiding the use of anticoagulants and antiplatelet drugs when possible, or holding these medications during of periods of time when the platelet count is very low, such as after a cycle of chemotherapy.

The use of anticoagulant therapy in patients with cancer should be carefully considered and individualized based on the patient's risk of thrombosis and bleeding.

How to treat Stroke (thrombotic and hemorrhagic)

Treatment of thrombotic stroke


Treatment of hemorrhagic stroke

References

1. Dardiotis E, Aloizou AM, Markoula S, et al. Cancer-associated stroke: Pathophysiology, detection and management (Review). Int J Oncol 2019;54(3):779-796.

2. Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 2019;50(12):e344-e418.

Created: March 28, 2024 Updated: March 28, 2024