Model System:

TBI

Reference Type:

Journal

Accession No.:

J78511

Journal:


Stroke

Year, Volume, Issue, Page(s):

, 48, 7, 1802-1809

Publication Website:

Abstract:

Study assessed the frequency of acute ischemic stroke (AIS) acutely after traumatic brain injury (TBI) in a large, multi-year, multicenter cohort of TBI patients. Data from 22 acute inpatient brain injury rehabilitation centers and their referring acute-care hospitals in the Traumatic Brain Injury Model Systems (TBIMS) National Database (NDB) were analyzed. Outcome measures were AIS incidence, duration of posttraumatic amnesia, Functional Independence Measure, and Disability Rating Scale, at rehabilitation discharge. Between October 1, 2007, and March 31, 2015, a total of 6488 patients with moderate-to-severe TBI were enrolled in the TBIMS NDB. One hundred fifty-nine (2.5 percent) patients had a concurrent AIS, and among these, median age was 40 years. AIS was associated with intracranial mass effect and carotid or vertebral artery dissection. High-velocity events more commonly caused TBI with dissection. AIS predicted poorer outcome by all measures, accounting for a 13.3-point reduction in Functional Independence Measure total score, a 1.9-point increase in Disability Rating Scale, and an 18.3-day increase in posttraumatic amnesia duration. Results indicate that ischemic stroke is observed acutely in 2.5 percent of moderate-to-severe TBI survivors and predicts worse functional and cognitive outcome. Half of TBI patients with AIS were aged ≤40 years, and AIS patients more often had cervical dissection. Vigilance for AIS is warranted acutely after TBI, particularly after high-velocity events.

Author(s):


Kowalski, Robert G., Haarbauer-Krupa, Juliet K., Bell, Jeneita M., Corrigan, John D., Hammond, Flora M., Torbey, Michel T., Hofmann, Melissa C., Dams-O'Connor, Kristen, Miller, A. Cate, Whiteneck, Gale G.

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