Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Ischemic Stroke Risk After Trauma in Young Cohort

Neurology; ePub 2017 Nov 8; Fox, Hills, et al

Stroke risk is elevated for 2 weeks after trauma, according to a recent study that examined the incidence, timing, and risk of ischemic stroke after trauma in a population-based young cohort. Since onset is frequently delayed, it provides an opportunity for stroke prevention during this period. However, in one-quarter of stroke cases with cerebrovascular angiography at the time of trauma, no vascular abnormality was detected. Researchers electronically identified trauma patients (aged <50 years) from a population enrolled in a Northern Californian integrated health care delivery system (1997–2011). They found:

  • From 1,308,009 trauma encounters, 52 trauma-related ischemic strokes were confirmed.
  • The 4-week stroke incidence was 4.0 per 100,000 encounters.
  • Trauma was multisystem in 26 (50%).
  • In 19 (37%), the stroke occurred on the day of trauma, and all occurred within 15 days.
  • In 7/28 cases with cerebrovascular angiography at the time of trauma, no abnormalities were detected.
  • In unadjusted analyses, head, neck, chest, back, and abdominal injuries increased stroke risk.
  • Only head and neck injuries remained associated with stroke after adjusting for demographics and trauma severity markers.

Citation:

Fox CK, Hills NK, Vinson DR, et al. Population-based study of ischemic stroke risk after trauma in children and young adults. [Published online ahead of print November 8, 2017]. Neurology. doi:10.1212/WNL.0000000000004708.