Editing Openai/697266a3-0c6c-8009-bc4a-9bba05ed9f98 (section)

=== Assistant: Successive recurrent strokes can occur on the same side of the brain, but how often this happens depends on the cause o… ===
Successive (recurrent) strokes can occur on the same side of the brain, but how often this happens depends on the cause of the strokes and risk-factor control. Here’s what is known from clinical data and neurology practice:

==== How common are recurrent strokes overall? ====
* ~20–25% of all strokes are recurrent strokes.
* Risk is highest: - First 90 days after a stroke (especially first 30 days) - Continues at ~3–5% per year thereafter without strong prevention

==== How often do recurrent strokes affect the same side? ====

There isn’t a single exact percentage reported in large studies, but patterns are well recognized:

===== 🔹 Same-side recurrence is common when the cause is localized =====

Recurrent strokes are more likely to occur on the same side when the underlying problem affects one side’s blood supply:

| Cause                                        | Likelihood of same-side recurrence |
| -------------------------------------------- | ---------------------------------- |
| Carotid artery disease (plaque or narrowing) | High (often same side)             |
| Small vessel (lacunar) disease               | Moderate–high                      |
| Prior hemorrhage from structural weakness    | High                               |
| Tumor- or radiation-related vascular damage  | High                               |

In these cases, the same vascular territory keeps failing, so recurrence often hits the same hemisphere.

===== 🔹 Opposite-side strokes are more likely with systemic causes =====

When strokes come from sources that affect the whole brain, later strokes may occur on either side:

| Cause                             | Pattern             |
| --------------------------------- | ------------------- |
| Atrial fibrillation / heart clots | Random side         |
| Severe hypertension               | Either side         |
| Hypercoagulable states            | Either side         |
| Vasculitis                        | Migrating locations |

==== Practical summary ====
* Yes — successive strokes often occur on the same side, especially if: - The original cause wasn’t corrected - There is fixed vascular damage on that side
* This is not rare and is well documented clinically
* Preventive treatment dramatically reduces recurrence risk

==== Why this matters clinically ====

Same-side recurrence can:
* Worsen existing deficits rather than create new ones
* Lead to cumulative damage in structures like the basal ganglia, internal capsule, or motor pathways
* Make symptoms appear to “flare” or stepwise worsen

==== Important note given your history ====

You previously mentioned a 3.4 cm lesion in the left basal ganglia.
That location is supplied by small penetrating arteries, which means:
* Recurrence risk is tied closely to blood pressure control
* Additional events, if they occur, often involve the same hemisphere

If you want, I can also explain:
* ⚠️ Warning signs of a same-side recurrent stroke
* 🧠 Why symptoms sometimes worsen without a new stroke
* 🛡️ Which prevention strategies matter most by stroke type

Just tell me what would help most.