The risk of stroke for patients with TBI is at its highest in the first four months after injury and remains significant for up to five years, new research has revealed.
TBI patients have an 86 per cent increased risk of stroke, when compared to patients who have not experienced a TBI.
Stroke risk may be at its highest in the initial four months post-injury, but remains a potential risk for the following five years, the University of Birmingham-led research finds.
Significantly, the findings suggest that TBI is a risk factor for stroke regardless of the severity or subtype of the injury – statistics show that up to 90 per cent of TBIs are mild, which researchers highlight as showing the stroke risk applies to even those who had few symptoms and are fully recovered.
Traumatic brain injury affects over 60 million people a year globally and studies have revealed the long-term risk of neurological diseases including dementia, Parkinson’s and epilepsy. The topic has come under renewed scrutiny through the recent investigations into links between concussion in sport and lasting neurological consequences.
The new research brings together 18 studies from four countries and is the first of its kind to investigate post-injury stroke risk.
“Stroke is the second leading cause of death and third leading cause of disability worldwide, however, urgent treatment can prevent stroke related death and long-term disability,” says Dr Grace Turner, lead author of the study from the University of Birmingham’s Institute of Applied Health Research.
“As our review has shown, TBI patients should be informed of the potential for increased stroke risk and with the risk of stroke at its highest in the first four months post-injury, this is a critical time period to educate patients and their care givers on stroke risk and symptoms,” says Dr Turner.
“This initial four-month period should also be used by clinicians to administer stroke prevention medication and lifestyle advice to mitigate the excess risk of stroke associated with TBI.”
Researchers also found that the use of anti-coagulants, such as VKAs and statins, could help to reduce stroke risk post-TBI, while the use of some classes of anti-depressants are associated with increased stroke risk post-TBI.
However, more research is required to investigate the effectiveness of stroke prevention drugs post-TBI to help inform clinicians’ prescribing and facilitate shared decision making, adds Dr Turner.
“Our review found some evidence to suggest an association between reduced stroke risk post-TBI and the stroke prevention drugs VKAs and statins but, as previous studies have found, stroke prevention drugs are often stopped when an individual experiences a TBI,” she says.
The review, published in the International Journal of Stroke, was funded by the National Institute for Health Research’s Surgical Reconstruction and Microbiology Research Centre based at University Hospitals Birmingham NHS Foundation Trust.
