Fluorouracil (5-FU) is a commonly used chemotherapeutic agent in many cancers. The widely reported adverse effects are infusion reactions, rash, fever, nausea, vomiting, peripheral neuropathy, and hepatic injury. However, there are limited data about its neurological side effects. Herein, we are reporting 3 cases of 5-FU induced neurovascular toxicities. Cerebral vasospasm with associated transient ischemia is a rare but significant adverse effect of the 5-FU. Stroke-like presentation makes timely recognition extraordinarily important. Differentiating stroke mimics is crucial as recombinant tissue plasminogen activator therapy should be given within a 4.5 hours window after an ischemic stroke. We suggest that 5-FU induced cerebral vasospasm can present with acute stroke-like symptoms. Physicians should be aware of stroke mimics as a differential diagnosis to spare their patients from unnecessary invasive and high-risk treatments.

氟尿嘧啶 (5-FU) 是许多癌症中常用的化学治疗剂。广泛报道的不良反应是输液反应、皮疹、发热、恶心、呕吐、周围神经病变和肝损伤。然而，关于其神经系统副作用的数据有限。在此，我们报告了 3 例 5-FU 引起的神经血管毒性。伴有短暂性缺血的脑血管痉挛是 5-FU 的一种罕见但显着的不良反应。笔画般的呈现使及时识别变得格外重要。区分中风模拟是至关重要的，因为重组组织纤溶酶原激活剂治疗应在缺血性中风后 4.5 小时内进行。我们建议 5-FU 诱导的脑血管痉挛可出现急性中风样症状。