Characterizing comorbid cerebrovascular insults among patients with TBI at a TBI model systems rehabilitation center

Model System:

TBI

Reference Type:

Journal article

Accession No.:

J84175

Journal:

Journal of Head Trauma Rehabilitation

Year, Volume, Issue, Page(s):

2019 , 35, 1, E51-E59

Publication Website:

Abstract:

Study determined the incidence and predictors of comorbid cerebrovascular injuries in patients with moderate-to-severe traumatic brain injury (TBI) and investigated whether it influences rehabilitation outcomes. Data on new traumatic cerebral artery injury (TCAI) lesions of head/neck and new cerebral infarcts (CIs) were abstracted from neuroimaging reports and clinical notes of 663 patients admitted to inpatient rehabilitation facilities participating in TBI Model Systems (TBIMS). The incidence of comorbid CI was 8 percent, among whom, 19 percent also had TCAI identified. The incidence of TCAI increased over time from 2 percent before 2008 to 10 percent after, probably from greater screening. Both CI and TCAI were associated with longer acute care stay. Cerebral infarct was also associated with longer posttraumatic amnesia and lower rate of functional gains. Using in-depth abstraction of imaging findings, the incidence of traumatic head/neck artery injuries, and CIs in patients with moderate-to-severe TBI were both higher than a recent TBIMS-wide study utilizing diagnosis codes. Cerebral infarct was associated with longer posttraumatic amnesia duration and slower functional gains. Further research is recommended on the outcome implications of concomitant cerebrovascular injury in patients with TBI.

Author(s):