Cancer and stroke have long been studied individually, but their detrimental forces
together have also been a strong point of focus. The occurrence of both cancer and
stroke in a patient is often a reflection of their similar risk factors (hypertension,
hyperlipidemia, diabetes, obesity, and smoking), however, a subgroup of the cancer
stroke population is believed to occur due to cancer-associated hypercoagulability.
A deeper look into the cancer-associated hypercoagulable environment has indicated
that thrombosis may be explained by cancer's role in several factors, including activation
of platelets and tissue factor, elevated expression of heparanase and influence on
neutrophilic extracellular traps. When a cryptogenic stroke (stroke lacking the aforementioned
risk factors) occurs due to the cancer-induced hypercoagulation state, patient serum
D-dimer levels have been found elevated, and CT/MRI images of the brain have shown
multivascular infarctions compared to stroke patients with traditional risk factors.
Additionally, cancer treatment - chemotherapy and radiation - have also been found
to increase the occurrence of cerebral vascular thrombosis. Further investigations
are required to better understand cancer-associated vascular pathophysiologic changes
and how to discern their unique strokes compared to strokes from other etiologies.
With these insights, the prevalence of strokes in the cancer population could be decreased.
