Acidente vascular cerebral em pacientes com câncer: uma revisão de literatura
Acidente vascular cerebral em pacientes com câncer: uma revisão de literatura
Data
2025
Autores
Campos, Samara Bianca Rodrigues de
Journal Title
Journal ISSN
Volume Title
Publisher
Instituto Nacional de Cardiologia
Resumo
Introdução: O acidente vascular cerebral (AVC) é uma das principais causas de incapacidade e mortalidade no mundo, e sua ocorrência em pacientes oncológicos representa um desafio clínico significativo. A presença do câncer aumenta o risco de AVC, enquanto o evento cerebrovascular impacta negativamente no prognóstico e na qualidade de vida dos pacientes. Nos últimos anos, evidências científicas têm destacando a importância de compreender essa inter-relação, uma vez que os mecanismos fisiopatológicos que ligam o câncer ao risco aumentado de AVC ainda não estão totalmente elucidados. Ademais, existem lacunas importantes sobre as melhores estratégias de prevenção e tratamento desses eventos, tornando essencial a realização de estudos adicionais. Objetivos: Realizar uma revisão de literatura sobre a associação entre câncer e AVC, analisando a influência da presença e da atividade tumoral no risco de ocorrência desse evento cerebrovascular. Método: Estudo do tipo revisão integrativa da literatura, com estratégia de busca online de artigos publicados nas bases de dados LILACS, PubMed, NLM e SciELO. Resultados: Após a aplicação dos critérios de inclusão e exclusão, a amostra final foi composta por 23 artigos, publicados entre os anos 1985 e 2017. Os estudos analisados indicam que pacientes com câncer têm um risco aumentado de AVC, tanto isquêmico quanto hemorrágico, o que agrava o prognóstico e reduz a sobrevida desses indivíduos. Os mecanismos subjacentes são diversos, incluindo hipercoagulabilidade, endocardite trombótica não bacteriana e trombose cerebrovascular. Além disso, terapias como quimioterapia e radioterapia também contribuem para o aumento do risco de eventos tromboembólicos. Certos tipos de câncer, como pulmão, pâncreas, colorretal e leucemias, apresentam maior associação com AVC, principalmente devido à sua agressividade e ao impacto nos processos de coagulação. O risco de AVC é mais elevado nos primeiros meses após o diagnóstico oncológico, tornando fundamental a atenção médica precoce. A identificação precoce do AVC relacionado ao câncer é essencial, sendo que biomarcadores, como o dímero-D e exames de imagem que evidenciem padrões sugestivos de embolia múltipla são ferramentas valiosas nesse contexto. Conclusão: A relação entre AVC e câncer é significativa, embora os mecanismos dessa associação ainda não estejam completamente esclarecidos. Contudo, ainda faltam protocolos clínicos padronizados para diagnóstico e tratamento. Dessa forma, estudos adicionais são necessários para desenvolver diretrizes eficazes, melhorar o manejo da condição e reduzir a morbidade e mortalidade desses pacientes.
Introduction: Stroke is one of the leading causes of disability and mortality worldwide, and its occurrence in cancer patients represents a significant clinical challenge. The presence of cancer increases the risk of stroke, while cerebrovascular events have a negative impact on patients' prognosis and quality of life. In recent years, scientific evidence has highlighted the importance of understanding this interrelationship, since the pathophysiological mechanisms linking cancer to the increased risk of stroke have not yet been fully elucidated. In addition, there are important gaps in the best strategies for preventing and treating these events, making further studies essential. Objectives: To carry out a literature review on the association between cancer and stroke, analyzing the influence of tumor presence and activity on the risk of this cerebrovascular event occurring. Method: An integrative literature review using an online search strategy for articles published in the LILACS, PubMed, NLM and SciELO databases. Results: After applying the inclusion and exclusion criteria, the final sample consisted of 23 articles, published between 1985 and 2017. The studies analyzed indicate that cancer patients have an increased risk of stroke, both ischemic and hemorrhagic, which worsens their prognosis and reduces their survival. The underlying mechanisms are diverse, including hypercoaguability, non-bacterial thrombotic endocarditis and cerebrovascular thrombosis. In addition, therapies such as chemotherapy and radiotherapy also contribute to an increased risk of thromboembolic events. Certain types of cancer, such as lung, pancreatic, colorectal and leukemia, have a greater association with stroke, mainly due to their aggressiveness and impact on coagulation processes. The risk of stroke is highest in the first few months after cancer diagnosis, making early medical attention essential. Early identification of cancer-related stroke is essential, and biomarkers such as D-dimer and imaging tests that show patterns suggestive of multiple embolism are valuable tools in this context. Conclusion: The relationship between stroke and cancer is significant, although the mechanisms of this association are not yet fully understood. However, standardized clinical protocols for diagnosis and treatment are still lacking. Thus, further studies are needed to develop effective guidelines, improve the management of the condition and reduce the morbidity and mortality of these patients.
Introduction: Stroke is one of the leading causes of disability and mortality worldwide, and its occurrence in cancer patients represents a significant clinical challenge. The presence of cancer increases the risk of stroke, while cerebrovascular events have a negative impact on patients' prognosis and quality of life. In recent years, scientific evidence has highlighted the importance of understanding this interrelationship, since the pathophysiological mechanisms linking cancer to the increased risk of stroke have not yet been fully elucidated. In addition, there are important gaps in the best strategies for preventing and treating these events, making further studies essential. Objectives: To carry out a literature review on the association between cancer and stroke, analyzing the influence of tumor presence and activity on the risk of this cerebrovascular event occurring. Method: An integrative literature review using an online search strategy for articles published in the LILACS, PubMed, NLM and SciELO databases. Results: After applying the inclusion and exclusion criteria, the final sample consisted of 23 articles, published between 1985 and 2017. The studies analyzed indicate that cancer patients have an increased risk of stroke, both ischemic and hemorrhagic, which worsens their prognosis and reduces their survival. The underlying mechanisms are diverse, including hypercoaguability, non-bacterial thrombotic endocarditis and cerebrovascular thrombosis. In addition, therapies such as chemotherapy and radiotherapy also contribute to an increased risk of thromboembolic events. Certain types of cancer, such as lung, pancreatic, colorectal and leukemia, have a greater association with stroke, mainly due to their aggressiveness and impact on coagulation processes. The risk of stroke is highest in the first few months after cancer diagnosis, making early medical attention essential. Early identification of cancer-related stroke is essential, and biomarkers such as D-dimer and imaging tests that show patterns suggestive of multiple embolism are valuable tools in this context. Conclusion: The relationship between stroke and cancer is significant, although the mechanisms of this association are not yet fully understood. However, standardized clinical protocols for diagnosis and treatment are still lacking. Thus, further studies are needed to develop effective guidelines, improve the management of the condition and reduce the morbidity and mortality of these patients.
Description
Palavras-chave
Acidente vascular cerebral, câncer, neoplasias, fatores de risco, diagnóstico, prevalência, Stroke, neoplasms, cancer, risk factors, diagnosis, prevalence.
Citação
Campos SBR. Acidente vascular cerebral: uma revisão de literatura. Rio de Janeiro. Trabalho de Conclusão de Curso [Programa de Pós-Graduação em Cardio-Oncologia]. Instituto Nacional de Cardiologia, 2025.