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.
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.
This Week's Must Reads
Tourette Syndrome, Tic Disorders, and Education, JAMA Neurology; ePub 2018 May 29; Pérez-Vigil, et al
RLS with PLMS More Common in Elderly Persons, Sleep; ePub 2018 Jun 1; Doan, Koo, Ogilvie, et al
Predicting Alpha-Synuclein Pathology Pre-Mortem, Parkinsonism Relat Disord; ePub 2018 May 17; Shprecher, et al
Excessive Daytime Sleepiness: Early Feature of DLB , Parkinsonism Relat Disord; 2018 May; Kasanuki, et al
HIV in HD Linked with Earlier Age of Symptom Onset, J Huntingtons Dis; 2018 Jun 1; Schultz, et al
Must Reads in Neurosurgery & Trauma
Ischemic Stroke Risk After Trauma in Young Cohort, Neurology; ePub 2017 Nov 8; Fox, Hills, et al
Aneurysm Linked with Fibromuscular Dysplasia in Women, JAMA Neurol; ePub 2017 Jul 17; Lather, et al
High Rate of Revisions, Removals in DBS Surgery, Parkinsonism Relat Disord; ePub 2016 Sep 12; Rolston, et al
Seizures and Periodic Discharges in Traumatic Brain Injury, Ann Neurol; ePub 2016 Feb 28; Vespa, Tubi, et al
Headache in Traumatic Brain Injury, Assessing associations with psychiatric comorbidities