Stroke risk is elevated in first weeks after head, neck trauma

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Takeaway

  • Patients with head or neck injuries had sharply higher adjusted risks for ischemic stroke within 4 wk.

Why this matters

  • The time-course and predictors of trauma-related ischemic stroke are not well defined.

Key results

  • The trauma population had a 4-wk incidence of 4.0 per 100,000 encounters.
  • Half of patients experiencing stroke had multisystem trauma.
  • All strokes occurred within 15 d of trauma, and 37% occurred on the day of trauma.
  • One-quarter of stroke patients who had cerebrovascular angiography at the time of did not have detectable arterial injury.
  • Patients had elevated unadjusted risk for stroke if they experienced head, neck, chest, back, or abdominal injuries.
  • Patients had elevated adjusted risk for stroke if they experienced head injuries (OR, 4.1; P=.031) or neck injuries (OR, 5.6; P=.046).

Study design

  • A 1997-2011 retrospective case-control study of patients <50 y old from an integrated health care delivery system: 52 who experienced ischemic arterial stroke within 4 wk and 156 who did not.
  • Main outcome was stroke.
  • Funding: American Heart Association; NIH.

Limitations

  • Population did not include older adults.
  • Some cases of stroke may have been missed or incorrectly attributed to trauma.