Cancer and stroke occur in similar patient populations, and they have similar traditional
risk factors (hypertension, hyperlipidemia, obesity, diabetes, and smoking), therefore,
it is beneficial to study the relationship between cancer and stroke. Patients diagnosed
with cancer have an increased incidence of acute ischemic cerebral events within the
first 6 months up to a year post diagnosis. The reverse relationship is also true
for patients diagnosed with stroke and then cancer. Interestingly, patients may have
a stroke as their first indication to an underlying developing cancer and will most
often be diagnosed with cancer sometime within six months to a year after the cerebral
incident. When cancer is diagnosed immediately after a cryptogenic stroke (unknown
etiology), the stroke may be a result of cancer -associated hypercoagulability. The
most common malignancies observed in the cancer-stroke patients are lung, breast and
melanoma. Currently, there are no pharmacologic recommendations for primary stroke
prevention in cancer patients. For acute ischemic stroke, life expectancy and the
potential for hemorrhagic complications should be con -sidered when deciding on thrombolytic
treatment. Only a few case series have been reported on mechanical thrombectomy in
malignancies, and there are no guideline recommendations yet. Secondary prevention
is advised through low molecular weight heparin. Understanding cancer-associated hypercoagulability
and the ways we can prevent the combined effects of cancer and stroke is a crucial
gap that requires further studies. Additionally, guides to aid in the recognition
of underlying malignancy in patients suffering from cryptogenic stroke need to be
estab-lished.
