Stroke in Children With Cancer: The Tip of the Iceberg?

We read with great interest the article by Noje et al. in which they analyzed the incidence and characteristics of stroke in children with cancer. Among a population of 1411 children with cancer, during a 10-year period registry, 15 children had stroke, corresponding to an overall prevalence of 1%. A slightly increased prevalence of stroke in children with brain tumors was documented (1.3%). The occurrence of stroke in children with brain tumors is potentiated by cranial radiation therapy. We are currently following a cohort of 103 adult survivors of childhood primary central nervous system tumors in our neurooncology clinic. They all underwent radiotherapy during childhood as part of their treatment protocol. Of these patients, two had stroke, grossly corresponding to a prevalence of 1.9%. This finding is consistent with the results presented by Noje et al. The two stroke cases occurred at the age of 4 years—19 months after tumor treatment in one patient—and at the age of 25 years—20 years after tumor treatment in the other patient. In both patients, we identified additional silent cerebrovascular lesions (cavernomas and microbleeds). In our cohort, the overall prevalence of late cerebrovascular complications such as microbleeds, cavernomas, stroke, superficial siderosis, and moyamoya syndrome identified by magnetic resonance imaging was 34.0%. These complications appeared any time during the follow-up period (median of 18.7 years after radiation therapy)...
Source: Pediatric Neurology - Category: Neurology Authors: Tags: Letters to the Editor Source Type: research