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Stroke Risk Increases Significantly After Traumatic Brain Injury

More than 60 million people worldwide experience a traumatic brain injury (TBI) each year. As recent medical innovations have increased the chances of surviving TBI, the number of people living with long-term side effects of TBI has also increased. Any person who has sustained TBI—regardless of injury severity—may experience these debilitating cognitive, psychological, neurological, and physical impairments in the weeks, months, and years following injury.

A particularly dangerous post-TBI complication is stroke, which occurs when a lack of blood supply to a part of the brain causes irreversible cell death and damage. Stroke is a leading cause of morbidity and mortality worldwide and is known to be associated with TBI, but no systematic literature review has characterized the association between TBI and stroke.

A research team recently addressed this gap by conducting a systematic review of 18 high-quality studies on TBI and stroke published before December 2020. Together, these 18 studies represented a large sample size of more than 2,600,000 patients from four countries. Using complex statistical analyses to pool results from all of the studies, the researchers determined that:

  • Patients who had experienced TBI were at significantly higher risk for stroke (86%) than uninjured patients.
  • Stroke risk is highest in the four months following injury but remains high for up to five years.
  • TBI is associated with increased stroke risk regardless of injury severity.
  • Certain antidepressants can increase stroke risk in the post-TBI period.

These findings indicate that all individuals who have experienced TBI, even those who experienced a mild injury or recovered well, are at increased risk for stroke in the years following the event. Fortunately, early detection and treatment of stroke can improve outcomes and prevent long-term stroke-related disability. During a stroke event, every minute counts. It is therefore critical to educate TBI patients about their stroke risk and to teach them and their loved ones to recognize the signs of stroke. Clinicians are encouraged to integrate stroke education in all patients’ post-TBI treatment plans.

Turner GM, McMullan C, Aiyegbusi OL, et al. Stroke risk following traumatic brain injury: Systematic review and meta-analysis. International Journal of Stroke. (June 2021).

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