Cancer an important stroke risk factor in kids

Children with cancer are at a higher risk of developing stroke and may benefit from targeted prevention strategies, a new study has found.

The study included 3,528 children aged 29 days to <19 years who had arterial ischaemic stroke (AIS; n=2,968) or cerebral sinovenous thrombosis (CSVT; n=596). Researchers found a history of remote or active cancer in 99 (3.3 percent) AIS patients and 64 (10.7 percent) CSVT patients. One cancer patient had both AIS and CSVT.

In the AIS subgroup, brain tumours were the predominant type of malignancy, accounting for 48 percent of all the cases, followed closely by haematological malignancies (40 percent). Fifty-four primary stroke episodes in this group had an identifiable cause.

Arteriopathy emerged as the most common correlate of primary stroke in AIS patients (63 percent). Brain tumours (38 percent) and haematologic malignancies (29 percent) were common in children with arteriopathy.

In the CSVT subgroup, haematologic malignancies (80 percent) were the most common type of cancer by a large margin, followed by brain tumours (11 percent). A prothrombic state was the predominant primary cause of CSVT, and was in turn associated with prior asparaginase therapy.

“Mechanistic studies of cancer-associated stroke are needed to guide efforts to prevent incident and recurrent stroke in this population,” researchers said.

“Though primary prevention of rare diseases such as paediatric stroke in a general population is not practical, identifying high-risk populations in whom prophylactic efforts can be directed may be critical in reducing the burden of childhood stroke,” they added.