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People under the age of 50 who experience a traumatic brain injury (TBI) have about a 1.9 times increased risk of stroke than people of the same age, according to a large analysis.
Even those who suffered a mild concussion had an increased risk of stroke compared to the general population of the same age, and the risk remained significantly higher even one year after the traumatic brain injury, a study showed.
Professor Leigh Ja-ho (left) and Research Professor Choi Yoon-jeong (Courtesy of Seoul National University Hospital)
Professor Leigh Ja-ho (left) and Research Professor Choi Yoon-jeong (Courtesy of Seoul National University Hospital)
On Friday, Seoul National University Hospital said that the study, led by Professor Leigh Ja-ho and Research Professor Choi Yoon-jeong of the Department of Rehabilitation Medicine, retrospectively compared the risk of stroke in 1.04 million traumatic brain injury patients under 50 and general population controls nationwide.
Traumatic brain injury is damage to the brain caused by an external impact, such as a car accident or fall.
It can range from relatively mild concussions to severe cases that include brain swelling, persistent coma, cerebral hemorrhage, and skull fractures. It is the leading cause of death among young adults worldwide and one of the leading risk factors for stroke.
Although stroke is recognized as a disease in older adults, its incidence has been increasing in younger adults. However, no study has systematically analyzed the risk of stroke in people under 50 who have experienced a traumatic brain injury.
The researchers tracked data from 1.04 million people aged 18-49 enrolled in the National Health Insurance Service (NHIS) for more than seven years, dividing them into a group of traumatic brain injury patients and an age- and gender-matched control group. Stroke was then categorized into cerebral infarction, cerebral hemorrhage, and subarachnoid hemorrhage to compare risk.
The result showed that the overall stroke incidence rate per 1,000 person-years (the probability of a stroke in a population of 1,000 people observed for one year) was 3.82 percent and 1.61 percent for patients and controls, respectively.
After adjusting for other variables, patients had a 1.89 times higher risk of overall stroke than controls. By type, cerebral hemorrhage had the highest risk (2.63 times), followed by subarachnoid hemorrhage and cerebral infarction (1.94 times and 1.60 times, respectively).
The risk of stroke also persisted for more than a year after traumatic brain injury. When only patients who had a TBI more than a year after the event were analyzed, the overall risk of stroke was 1.09 times higher than in the control group, and the risk of cerebral hemorrhage was 1.2 times higher.
The researchers further sub-analyzed the data by type of traumatic brain injury: concussion, non-concussive injury, and skull fracture.
The results showed that the risk of cerebral hemorrhage increased about nine-fold and five-fold, respectively, in the non-concussion injury group, including traumatic brain edema, diffuse or focal brain injury, epidural hemorrhage, subdural or subarachnoid hemorrhage, and persistent coma, and in the skull fracture group, compared to the control group, but even the milder types of concussion were associated with about a twofold increased risk of cerebral hemorrhage.
The researchers emphasized that relatively young adults who are often physically active, such as in sports, should not take concussions lightly and should pay special attention to stroke prevention.
“Even adults under 50 who have experienced a traumatic brain injury should make efforts to prevent stroke early by, for instance, managing blood sugar and cholesterol through regular checkups and practicing a healthy lifestyle,” Professor Lee said. “In particular, relatively younger traumatic brain injury patients tend to overlook their risk of stroke, so it is necessary to raise awareness of stroke prevention among them.”
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Kim Kyoung-Won kkw97@docdocdoc.co.kr
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