Traumatic Brain Injury causes 10-fold increase In Stroke Risk

In a new study reported in Stroke: Journal of the American Heart Association, researchers reported that an individual suffering from a traumatic brain injury has a 10-fold increased risk of having a stroke within the first three months.
Senior study author and professor at the School of Health Care Administration, College of Medicine, Taipei Medical University in Taiwan, Herng-Ching Lin, Ph.D, said: “It’s reasonable to assume that cerebrovascular damage in the head caused by a traumatic brain injury can trigger either a hemorrhagic stroke [when a blood vessel bursts inside the brain] or an ischemic stroke [when an artery in the brain is blocked]. However, until now, no research had been done showing a correlation between traumatic brain injury and stroke.”

This is the first study that evaluates and identifies traumatic brain injury as a potential risk factor for consequent stroke.

An external force such as a smack, blow, or jerk to the head that interferes with normal brain function results in a traumatic brain injury. Falls, vehicle accidents, and violence, may be few of the causes.

CDC statistics for 2004 reveal that approximately 1 in 53 individuals in the US alone sustain a traumatic brain injury each year.
Traumatic brain injury is the primary reason for physical impairment, social disruption, and deaths worldwide.
Over a period of 5 years, researchers used records from a nationwide Taiwanese database to investigate stroke risk in traumatic brain injury patients. The records comprised 23,199 adult traumatic brain injury patients who received ambulatory or hospital care from 2001 to 2003. The control group included 69,597 non-traumatic brain injury patients. Nearly 54% of the patients were male with an average age 42 years.

A 10-fold difference in stroke rates was observed during the three months after injury. While only 0.30 percent of patients with non-traumatic brain injury suffered a stroke, the number of traumatic brain injury patients to have suffered a stroke was 2.91 percent.

Researchers said that stroke risk in traumatic brain injury patients gradually decreased over time:

• Stroke risk was 4.6 times greater in patients who suffered a traumatic brain injury compared to others who did not. (After 1 year).
• Stroke risk was 2.3 times greater in patients who suffered a traumatic brain injury compared to others who did not. (After 5 years).

Researchers also said that traumatic brain injury patients with skull bone fractures had a more prominent stroke risk than those without fractures.

During the first three months, stroke risk was 20 times higher in patients with skull bone fractures than in those without skull bone fractures; nonetheless, the risk decreased over time.

In addition, compared with non-traumatic brain injury patients, traumatic brain injury patients were at an increased risk developing of subarachnoid hemorrhages (bleeding in the area between the brain and the thin tissues that cover the brain) and intracerebral hemorrhages (bleeding in the brain caused by the rupture of a blood vessel).

Taking into account the age and gender of patients, the likelihood of developing hypertension, diabetes, coronary heart disease, atrial fibrillation, and heart failure was higher in traumatic brain injury patients than in non-traumatic brain injury patients.

Lin said that during the first few months and years following a traumatic brain injury, patients should undergo early neuroimaging examinations such as MRI and must receive intensive medical monitoring, support, and intervention. Furthermore, improved health education initiatives can increase public awareness about the causes of stroke as well as stroke symptoms in traumatic brain injury patients.

Lin concluded: “Stroke is the most serious and disabling neurological disorder worldwide. Our study leads the way in identifying stroke as an additional neurological problem that may arise following traumatic brain injury.”

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