Traumatic Brain Injury Increases Stroke Risk
June 27, 2013

Traumatic Brain Injury May Also Elevate Stroke Risk, Says New Study

Brett Smith for - Your Universe Online

People who suffer a traumatic brain injury (TBI) often have to learn to cope with physical or mental difficulties after the event. Now, a new study in the journal Neurology shows that they may also face double jeopardy from increased risk of stroke.

"Both stroke and traumatic brain injury are common, costly and leading causes of severe disability in adults, and approximately 20 percent of strokes occur in adults under age 65," said study author Dr. James F. Burke, a neurologist at the University of Michigan. "A large proportion of stroke risk is unexplained, especially in the young, so if we can identify new risk factors, we have the potential to prevent more strokes and improve outcomes."

In the study, researchers culled through five years of California hospital records for adults who either went to the emergency room or were admitted to a hospital for TBI or other trauma without brain injury. Almost 440,000 people with TBI were included in the study along with about 740,000 trauma victims who showed no signs of brain trauma.

After an average of around 28 months, one percent of all those included in the study suffered an ischemic stroke, which broke down into 1.1 percent of people with TBI and 0.9 percent of those who only suffered bodily trauma. Eighty percent of all strokes are ischemic, which occurs when blood flow to the brain is impeded.

After the researchers took confounding factors into consideration - including high blood pressure, cardiovascular health and age, along with the severity of the initial trauma - they found that people with TBI were 30 percent more likely to develop a stroke than those who had suffered trauma without signs of brain injury.

"While the stroke risk of one person with TBI is small, the overall link between TBI and stroke was substantial - as large as the link between the strongest stroke risk factor, high blood pressure, and stroke," Burke said. "If further research establishes TBI as a new risk factor for stroke, that would stimulate research to help us understand what causes stroke after TBI and help us learn how to prevent these strokes."

Approximately 1.7 million TBIs occur annually, according to statistics from the Centers for Disease Control and Prevention (CDC). These play a role in over 30 percent of all injury-related deaths in the United States. The CDC estimates that the medical costs and lost productivity resulting from TBIs in 2000 was around $76.5 billion.

TBI experts say the first hour after the trauma, referred to as the "golden hour," is the most critical in treating a potential brain injury. Treatment during this time depends on the severity of the trauma, but it can include surgical intervention to stop internal bleeding in the brain.

Most immediate treatments involve ensuring that the brain is receiving enough blood and oxygen following a trauma. This is typically done by ensuring proper breathing, ventilation and blood pressure. Once patients are stabilized, treatment shifts from damage mitigation to rehabilitation, which focuses on patients independently functioning at home or in society.