What are the chances of another stroke?

A fellow caregiver asked...

A year ago, when I was 30, I had a significant stroke. I had no significant symptoms, and recovered rapidly from the event. I've been to multiple specialists, and none of them can determine why I had a stroke (ischemic). I am not on any mediations, besides a baby asprain a day. What are the chances of a second stroke, and what can I do to prevent another stroke from happening?

Expert Answer

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

The chances of having a second stroke depend a great deal on what caused the initial stroke.  In someone your age, the usual causes of stroke are 1) a tear in the artery, 2) an inborn problem with the arteries, 3) inborn heart disease - such as a hole in the heart, or 4) a clotting disorder.

I would make sure you see a stroke specialist.  Seeing a general Neurologist may not be sufficient.  A stroke specialist may have additional ideas and testing that was not considered.

That said, a fairly large number of people with stroke at a young age do not have an identifiable cause.  Luckily, this group has a relatively low recurrence risk.  It is the patients WITH an identifiable cause that are the most troubling, because they are more likely to have a recurrence.  I cannot quote you an exact figure, but if you have been thoroughly examined (by a stroke physician) and no underlying cause has been found, you should have a very low recurrence risk.