BackgroundPatients with malignancies have an increased risk of suffering ischemic stroke via several mechanisms such as coagulation dysfunction and other malignancy‐related effects as well as iatrogenic causes. Moreover, stroke can be the first sign of an occult malignancy, termed as malignancy‐associated ischemic stroke (MAS). Therefore, timely diagnostic assessment and targeted management of this complex clinical situation are critical.FindingsPatients with both stroke and malignancy have atypical ages, risk factors, and often exhibit malignancy‐related symptoms and multiple lesions on neuroimaging. New biomarkers such as eicosapentaenoic acid and blood mRNA profiles may help in distinguishing MAS from other strokes. In terms of treatment, malignancy should not be considered a contraindication, given comparable rates of recanalization and complications between stroke patients with or without malignancies.ConclusionIn this review, we summarize the latest developments in diagnosing and managing MAS, especially stroke with occult malignancies, and provide new recommendations from recently emerged clinical evidence for diagnostic and therapeutic workup strategies.

中文翻译：

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恶性肿瘤相关缺血性中风：对诊断和治疗检查的意义

背景恶性肿瘤患者通过多种机制，如凝血功能障碍和其他恶性肿瘤相关效应以及医源性原因，患缺血性中风的风险增加。此外，中风可能是隐匿性恶性肿瘤的第一个征兆，称为恶性肿瘤相关缺血性中风（MAS）。因此，对这种复杂的临床情况进行及时的诊断评估和有针对性的管理至关重要。研究结果脑卒中和恶性肿瘤患者的年龄、危险因素不典型，并且在神经影像学上经常表现出恶性肿瘤相关症状和多发病变。新的生物标志物，如二十碳五烯酸和血液 mRNA 谱，可能有助于区分 MAS 和其他中风。在治疗方面，考虑到伴或不伴恶性肿瘤的卒中患者的再通率和并发症率相当，恶性肿瘤不应被视为禁忌症。结论在这篇综述中，我们总结了诊断和治疗 MAS 的最新进展，特别是伴有隐匿性恶性肿瘤的卒中根据最近出现的临床证据为诊断和治疗检查策略提供新的建议。