Traumatic brain injury may be an independent risk factor for stroke

Burke, James F.; Stulc, Jessica L.; Skolarus, Lesli E.; Sears, Erika D.; Zahuranec, Darin B.; Morgenstern, Lewis B.

doi:10.1212/wnl.0b013e318297eecf

Cited by 123 publications

(119 citation statements)

References 32 publications

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“…TBI is not currently identifi ed as a risk factor for stroke. However, one trauma database found that 37% of trauma patients are admitted secondary to TBI and, in a 2½-year follow-up period, patients who suff ered a TBI had a 31% increased risk of being hospitalized secondary to ischemic stroke over non-TBI trauma patients ( 27 ).…”

Section: Resultsmentioning

confidence: 99%

The Impact of Preexisting Illness and Substance Use on Functional and Neuropsychological Outcomes Following Traumatic Brain Injury

Dahdah

Barnes

Buros

et al. 2016

Baylor University Medical Center Proceedings

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Traumatic brain injury (TBI) is a significant public health problem in the US. Specific preexisting medical illnesses delay recovery after TBI and increase mortality or risk of repeat TBI. This study examined the impact of preexisting illness and substance use on patient rehabilitation outcomes following TBI. The Functional Independence Measure total score and Disability Rating Scale score measured functional outcomes at discharge from inpatient rehabilitation, while the Trail Making Test A and B and Total Trials 1-5 of the California Verbal Learning Test-II measured neuropsychological outcomes in 128 TBI survivors with moderate or severe TBI. Results showed that the presence of a heart condition or diabetes/ high blood sugar was associated with lower functional outcomes by discharge. A history of a heart condition, stroke, or respiratory condition prior to TBI was associated with reduced cognitive flexibility. Those with preexisting diabetes/high blood sugar demonstrated poorer visual attention, visuomotor processing speed, and ability to learn and recall verbal information. Those with pre-TBI cancer also had greater auditory-verbal memory deficits. The findings showed that specific preexisting medical conditions are independently associated with lower functional and cognitive outcomes for patients with TBI. By screening patients for preexisting medical conditions, multidisciplinary TBI rehabilitation teams can identify patients who require more aggressive treatments or greater length of stay.T he purpose of this study was to examine the relation of preexisting medical illnesses and substance use with both functional status and neurocognitive status at the time of discharge from inpatient rehabilitation in individuals with traumatic brain injury (TBI). Preexisting cancer, preexisting liver disease, and use of tobacco/cigarettes were included, as few studies have examined their association with post-TBI functional outcomes. No studies to date have evaluated the impact of preexisting medical illnesses on neuropsychological outcomes. METHODSTh is study was part of the Traumatic Brain Injury Model System (TBIMS), with data collected at a center in an urban metroplex in the Southern US ( 1 ). TBIMS is a longitudinal multicenter, prospective, observational study of patients aged ≥16 years who sustained a moderate to severe TBI due to blunt or penetrating injuries. Additional information regarding TBIMS inclusion criteria and the defi nition of TBI can be found in Dijkers, Harrison-Felix, and Marwitz's historical review of the TBIMS ( 1 ). Patients with concomitant spinal cord injury, whose inpatient rehabilitation course exceeded 90 days, or who died during their inpatient rehabilitation stay were excluded from this study. Collection of preexisting medical illnesses and substance use information was initiated in October 2012. Th erefore, 138 patients enrolled in the TBIMS longitudinal study between October 1, 2012, and November 5, 2013, were screened for inclusion in this retrospective study. Of 138 screened patients...

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Section: Resultsmentioning

confidence: 99%

The Impact of Preexisting Illness and Substance Use on Functional and Neuropsychological Outcomes Following Traumatic Brain Injury

Dahdah

Barnes

Buros

et al. 2016

Baylor University Medical Center Proceedings

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“…[15] This is, especially, a matter of concern in patients with severe and critical TBI with GCS≤8 and DAI, since, pre-hospital neurologic deterioration and lower level of consciousness are independent factors of poor prognosis. [16,17] Severe traumatic brain injury is an isolated predisposing factor for succeeding posttraumatic cerebral infarction (PTCI); [18,19] in this setting, besides acute reperfusion strategies such as thrombolysis or mechanical clot removal, practically all available therapeutic protocols focus on palliation and use of neuroprotective agents for mitigation of secondary damage to the nervous system. Citicoline has been reported to have protective and restorative effects on the central nervous system (CNS) by inducing Na + /K + ATPase activity, decreasing lipid peroxidation, preserving mitochondrial membrane cardiolipin, suppressing phospholipase A 2 activity, improving neuroplasticity and synthesis of neurotransmitters like acetylcholine (Ach) or dopamine.…”

Section: Discussionmentioning

confidence: 99%

Effects of Citicoline on Level of Consciousness, Serum Level of Fetuin-A and Matrix Gla- Protein (MGP) in Trauma Patients with Diffuse Axonal Injury (DAI) and GCS≤8

Shokouhi

Haghjoo

Sattarnezhad

et al. 2014

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Citicoline, a neuroprotective drug, has been suggested to improve level of consciousness, mitigating secondary to brain damage and ectopic vascular calcification, following post-traumatic neurogenesis and angiogenesis, inducing calcification modulators, like fetuin-A and matrix Gla-protein (MGP). This study aimed to investigate effects of citicoline on levels of consciousness, serum levels of fetuin-A and MGP in patients with severe traumatic brain injury.

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“…Studies have found that TBI is associated with increased risk of stroke [10][11][12]. Although the actual mechanism is still not completely understood, several hypotheses have been proposed.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, in several studies TBI was found to be associated with increased risk of [10][11][12]. Because stroke results from disturbance of the blood supply to the brain, it has been hypothesized that vascular damage from TBI may also induce stroke in survivors [11].…”

Section: Introductionmentioning

confidence: 99%

339 Increased Risk of Ischemic Stroke in Patients With Mild Traumatic Brain Injury: A Nationwide Cohort Study

Cheng

Lee

2014

Annals of Emergency Medicine

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Traumatic brain injury may be an independent risk factor for stroke

Abstract: In this large cohort, TBI is associated with ischemic stroke, independent of other major predictors.

Cited by 123 publications

References 32 publications

The Impact of Preexisting Illness and Substance Use on Functional and Neuropsychological Outcomes Following Traumatic Brain Injury

The Impact of Preexisting Illness and Substance Use on Functional and Neuropsychological Outcomes Following Traumatic Brain Injury

Effects of Citicoline on Level of Consciousness, Serum Level of Fetuin-A and Matrix Gla- Protein (MGP) in Trauma Patients with Diffuse Axonal Injury (DAI) and GCS≤8

339 Increased Risk of Ischemic Stroke in Patients With Mild Traumatic Brain Injury: A Nationwide Cohort Study

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