ISCHEMIC STROKE AND HEMOSTASIS DISORDERS IN ONCOLOGICAL PROCESS: A LITERATURE REVIEW

Abstract

Malignant neoplasms are associated with an increased risk of developing acute cerebrovascular accidents. This article provides a review of the literature on hemostatic disorders during oncological processes in patients with ischemic stroke. Cancer-associated stroke can develop for several reasons, including direct effects of the tumor, as well as indirectly through the development of blood coagulation disorders, concomitant infectious diseases, or complications of antitumor therapy. One of the most common pathogenetic mechanisms is cancer-associated coagulopathy. Trousseau syndrome is a variant of paraneoplastic syndrome, characterized by a state of hypercoagulability with the development of thrombosis that precedes the diagnosis of a malignant neoplasm or develops simultaneously with it. Cerebral ischemia in Trousseau’s syndrome is characterized by a multifocal pattern of lesions according to neuroimaging data. To date, there are no clear diagnostic criteria for cancer-associated stroke, which is often one of the first clinical manifestations of the oncological process. According to various studies, laboratory markers of hypercoagulability can serve as predictors of previously undiagnosed malignancy in patients with cryptogenic ischemic stroke. Currently, more and more attempts are being made to develop diagnostic scales based on clinical and neuroimaging characteristics of stroke to identify hidden oncological processes. Another important aspect of the issue remains the lack of evidence-based recommendations for the treatment of ischemic stroke associated with cancer. Given the prevalence of stroke in cancer patients, potentially poor functional prognosss, higher rates of post-stroke mortality and high relapse rates, further research into this issue is required.