Neurologic complications of systemic cancer

Neurologic complications occur frequently in patients with cancer. After ro utine chemotherapy, these complications are the most common reason for hosp italization of these patients. Brain metastases are the most prevalent comp lication, affecting 20 to 40 percent of cancer patients and typically prese nting as headache, altered mental status or focal weakness. Other common me tastatic complications are epidural spinal cord compression and leptomening eal metastases. Cord compression can be a medical emergency, and the rapid institution of high-dose corticosteroid therapy, radiation therapy or surgi cal decompression is often necessary to preserve neurologic function. Lepto meningeal metastases should be suspected when a patient presents with neuro logic dysfunction in more than one site. Metabolic encephalopathy is the co mmon nonmetastatic cause of altered mental status in cancer patients. Cereb rovascular complications such as stroke or hemorrhage can occur in a variet y of tumor-related conditions, including direct invasion, coagulation disor ders, chemotherapy side effects and nonbacterial thrombotic: endocarditis. Radiation therapy is the most commonly employed palliative measure for meta stases. Chemotherapy or surgical removal of tumors is used in selected pati ents.