In a study published in Neurology on June 26, researchers have found a strong association between traumatic brain injury and future development of ischemic stroke. The association is strong even with considerations for potential confounders, such as vascular risk factors and secondary or tertiary conditions. According to the researchers, the association is similar in intensity to the one between hypertension and ischemic stroke.
The “retrospective cohort study” included more than a million patients in California who had experienced a TBI or non-TBI from 2005 to 2009. Approximately 37 percent had a TBI. The researchers analyzed the health of the patients during a follow-up period 28 months, finding that there were 11,229 ischemic strokes among the patients. About 1.1 percent of the strokes occurred among the TBI group, and 0.9 percent occurred in the non-TBI group. According to MedScape, the researchers noted that “TBI was robustly associated with ischemic stroke after adjusting for demographic characteristics, vascular risk factors, comorbid conditions, trauma severity and trauma mechanism.”
The researchers have two main theories regarding the association. One theory is that TBI could lead to cognitive behavior changes that could in turn lead to changes in patterns of behavior. The change in patterns of behavior could lead a TBI patient to pick up other conditions that are associated with stroke, including hypertension, more frequently than patients without TBI. The researchers also theorize that the association could be through vascular dissection, “a well-known stroke mechanism that has already been linked to TBI,” according to MedScape.
In the future, the researchers are open to the possibility of assessing a greater number of patients with TBI, such as those in the military. However, the researchers say they would most likely use a different method of study.