Cerebrovascular disorders in patients with malignant tumors

Abstract

Patients with malignant tumors face an elevated risk of cerebrovascular complications, such as intratumoral hemorrhage, tumor invasion into arterial and venous sinuses, leptomeningeal infiltration, and tumor embolism. This review examines the significant role and implications of cisplatin and radiation therapy in the development of these cerebrovascular complications, which can occur at various stages: before, during, or long after the completion of cancer treatment. Detailed clinical case studies of CNS involvement during oncological therapy are presented to illustrate these complications. The mechanisms by which cisplatin and radiation therapy contribute to cerebrovascular disorders are multifaceted. Cisplatin, a widely used chemotherapeutic agent, is associated with endothelial damage and thromboembolic events, while radiation therapy can cause vascular injury, leading to long-term changes in cerebral vasculature. These treatments, though effective in managing malignancies, pose significant risks to cerebrovascular health. The review underscores the diverse types and mechanisms of stroke encountered in cancer patients, influenced by tumor stage and pathological characteristics. These include ischemic stroke, hemorrhagic stroke, and transient ischemic attacks, each requiring specific diagnostic and therapeutic strategies. The interaction between cancer pathology and cerebrovascular health necessitates a multidisciplinary approach, integrating oncology, neurology, radiology, and vascular surgery. Such an approach is crucial for effective management and prognosis evaluation in this patient population. Early recognition and intervention are paramount to mitigating risks and improving outcomes. By understanding these complex interactions, healthcare providers can better anticipate and manage cerebrovascular risks in patients undergoing cancer treatment. This comprehensive understanding helps in formulating personalized treatment plans, optimizing both oncological and neurological care, and ultimately enhancing patient quality of life and survival rates.