Prior head injury is associated with a 34% increased risk of stroke in older adults
By Sravya Valiveti. This article was initially published in the 6/27/24 edition of our Concussion Update newsletter; please consider subscribing.
A press release from Penn Medicine News highlighted that individuals with a history of traumatic brain injury (TBI) were at higher risk of developing an ischemic stroke later in life. Ischemic stroke is a type of stroke that is characterized by a blood clot in the brain. This new research, published in Stroke, evaluated data over 30 years for 13,000 adults and showed that those with prior head injury were overall 34% more likely to have a stroke than those who never suffered a brain injury. At baseline, the study participants were a median of 54 years old, had no history of TBI or stroke, and none were in hospitals or nursing homes at the follow-up (a median of 27 years later). Head injuries varied in severity, from mild concussions to skull fractures and other head trauma. Holly Elser et al. found that there was a dose-response relationship; those with one head injury had a 16% increased risk of stroke, while those with two or more head injuries had a 94% increased risk of having an ischemic stroke. The research team also found that the head injury severity did not influence the increased risk of stroke, but multiple head injuries showed a strong association with more severe stroke later in life.
It is worth noting that these new findings shed light on the relationship between brain injury and its long-term impacts on brain health and stroke risk later in life, which adds to other recent research that also found associations between brain injury and other long-term conditions such as dementia and late-onset epilepsy, as well as disability status. This establishes a need for early intervention in those who are at higher risk of stroke due to a history of head injury alone. The lead author, Holly Elser, a Neurology resident at Penn Medicine, stated that clinicians should counsel those patients who are at higher risk on lifestyle changes and measures that can help patients monitor the risk and manage the risk factors associated with a stroke such as high blood pressure and high cholesterol. She also called for better prevention and safety measures, such as wearing bike helmets and seatbelts that protect against more severe brain injury to hopefully mitigate the long-term risk of developing future conditions associated with brain injury.