5-Fluorouracil associated neurovascular toxicities

Area of Science:

• Oncology
• Neurology
• Pharmacology

Background:

• Fluorouracil (5-FU) is a cornerstone chemotherapeutic agent for various cancers.
• While known for common side effects, its neurological adverse events are less documented.
• Neurovascular complications, including cerebral vasospasm, are rare but serious 5-FU toxicities.

Observation:

• This report details 3 cases of 5-FU-induced neurovascular toxicities.
• Patients presented with stroke-like symptoms attributed to cerebral vasospasm and transient ischemia.
• These presentations highlight the potential for 5-FU to mimic acute ischemic stroke.

Findings:

• 5-FU-induced cerebral vasospasm can manifest as acute, stroke-like neurological deficits.
• Timely identification of these 5-FU neurotoxicities is critical for effective clinical decision-making.
• Distinguishing these stroke mimics from actual ischemic strokes is essential for treatment selection.

Implications:

• Awareness of 5-FU neurovascular toxicity is crucial for oncologists and neurologists.
• Recognizing 5-FU-induced cerebral vasospasm can prevent misdiagnosis and inappropriate thrombolytic therapy.
• This understanding aids in avoiding high-risk treatments in patients experiencing stroke mimics.