People who survived cancer and had a stroke in childhood have a risk of a second stroke that is doubled, compared with people who did not have cancer but did have a stroke, according to a study that was published online August 26 in Neurology. 

Lead author Heather J. Fullerton, MD, and colleagues analyzed retrospective data and tracked long-term outcomes of treatment among 14,358 individuals who received a diagnosis of cancer before age 21 years and were enrolled in the Childhood Cancer Survivor Study.

The researchers assessed stroke recurrence rates by sending surveys to participants who had reported a first stroke and asking them to report whether they had had a second stroke. Of the 271 respondents who reported having had a stroke, 70 reported a second stroke.

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The rate of recurrence within the first 10 years after an initial stroke was 21%, which is double the rate observed in the general population of stroke survivors. For patients who underwent cranial radiation therapy, the rate was 33%. 

The researchers found that the main predictors of recurrent stroke were cranial radiation therapy, hypertension, and older age at first stroke. Screening for modifiable stroke risk factors and blood vessel injury using MRI could be valuable and has been added to protocols at the authors’ institution.