Introduction | Section 1 | Section 2 | Section 3 | Conclusion and References |
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Section 2 - Other
CNS disease related to underlying and secondary effects of malignancy
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Hematologic/ Cerebrovascular: Intracranial hemorrhageHemorrhage: Hemorrhage can be particularly dangerous and life threatening in leukemics. These bleeds can be intraaxial (cases 13 and case 14) or extraaxial (case 15), but intraparenchymal bleeds are the most feared. These tend to be multiple small rounded areas of hemorrhage in the subcortical white matter, often surrounded by a small collar of edema (case 13). Typically these patients present with a sudden onset of headache and/or neurologic deterioration, and possibly seizure. Patients with fulminant leukocytosis ("blast crisis"), are at particular risk for hemorrhage. In these patients, especially those with leukocyte counts greater than 300,000 per cu. mm, blast cell thrombi within small arterioles-"leukostasis"- can cause vascular destruction, and lead to massive hemorrhage (case 14). Spinal subdural hematoma may occur as a complication of diagnostic lumbar puncture, in patients with thrombocytopenia.
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