Research Reports - Increased risk of stroke in patients of concussion
Int J Environ Res Public Health. 2017 Feb 25;14(3). pii: E230. doi:
Liu SW(1), Huang LC(2), Chung WF(3), Chang HK(4), Wu JC(5,)(6), Chen LF(7,)(8),
Chen YC(9,)(10,)(11), Huang WC(12,)(13), Cheng H(14,)(15), Lo SS(16).
Long-term morbidities can develop after traumatic brain injury (TBI). Some
studies have suggested that the risk of stroke is higher after TBI, but the
association between concussion and stroke remains unclear. Using a national
cohort, the authors analyzed the incidence of both hemorrhagic and ischemic
strokes in patients with previous concussion. A representative cohort of
approximately one million people was followed up for four years. Patients with
new-onset concussion were identified (n = 13,652) as the concussion group.
Subsequently, the incidence rates of later stroke events in the concussion group
were compared to a sex-, age- and propensity score-matched comparison group (n =
13,652). The overall incidence rate of stroke in the concussion group was higher
than that of the comparison group (9.63 versus 6.52 per 1000 person-years, p <
0.001). Significantly higher stroke risk was observed in the concussion group
than in the comparison group (crude hazard ratio 1.48, p < 0.001; adjusted HR
1.65, p < 0.001). In the concussion group, the cumulative incidence rates of both
ischemic stroke and hemorrhagic stroke were higher than those of the comparison
group (8.9% vs. 5.8% and 2.7% vs. 1.6%, respectively, both p < 0.001). Concussion
is an independent risk factor for both ischemic and hemorrhagic strokes.
Prevention and monitoring strategies of stroke are therefore suggested for
patients who have experienced concussion.