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Traumatic brain injury increases the risk of debilitating strokes and death, but also dramatically impacts the ongoing costs associated with caring for the patient, says Alabama traumatic brain injury lawyer Keith T. Belt.
The risk of ischemic stroke increased modestly but significantly following traumatic brain injury (TBI), according to a review of more than 400,000 cases. Ischemic strokes occur as a result of an obstruction within a blood vessel supplying blood to the brain. TBI was associated with a 31% greater risk of stroke compared with trauma patients whose injuries did not affect the brain. A significantly increased risk persisted after adjustment for potentially confounding factors.
Although the absolute increase in risk was 0.2%, the higher prevalence of TBI in trauma patients translated into a bigger contribution to ischemic stroke than hypertension, the leading risk stroke risk factor, James F. Burke, MD, of the University of Michigan in Ann Arbor, and co-authors reported in the July 2 issue of Neurology.
The findings add support to a previous Taiwanese study, which showed a higher stroke risk associated with TBI compared with a non-trauma control group. Stroke and TBI cause substantial disability among working-age adults, as 20% of strokes and more than 40% of TBIs occur in adults younger than 65. A large proportion of strokes in younger people remain unexplained. Identification of risk factors in that subgroup of patients might lead to development of prevention strategies to reduce stroke rates in younger adults.
In theory, trauma to the head and neck could increase stroke risk by several means, including vascular dissection, micro vascular injury, and abnormal coagulation. The Taiwanese observational study showed an association between TBI and all strokes, but the strongest relationship involved known effects of TBI (subarachnoid and intracerebral hemorrhage). Much of the increased stroke risk occurred in the first month after TBI, suggesting that some events classified as stroke might have been squeal of TBI.
Investigators compared TBI and non-TBI trauma patients, adjusting for as many confounders as possible. They defined TBI according to CDC guidelines. They limited the analysis to patients with minor strokes and transient ischemic attacks. Of 1,173,353 trauma patients, 436,630 (37%) had a TBI. Patients with TBI were slightly younger, were less likely to be women and had a higher injury severity score.
The magnitude of the association between TBI and ischemic stroke remained similar when stroke hospitalization was categorized by intervals ranging from 7 to 365 days from traumatic injury. An age-stratified analysis resulted in the greatest change, as patients younger than 50.
If you or a loved one has suffered from a devasting moderate or severe traumatic brain injury, call the traumatic brain injury lawyers from Belt, Bruner, & Barnett P.C. at (205) 933-1500 or use our online form. With offices in Birmingham, Mobile, Huntsville, and Montgomery, our lawyers will quickly travel to investigate your case.