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Head injuries increase the risk of hemorrhagic stroke tenfold
Last reviewed: 30.06.2025
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After a traumatic brain injury (TBI), the risk of stroke increases tenfold in the following three months, according to a team of scientists from the College of Medicine at Taipei Medical University (Taiwan).
Cerebrovascular injuries in the head caused by brain trauma can trigger either a hemorrhagic stroke (when a blood vessel bursts inside the brain) or an ischemic stroke (when an artery in the brain becomes blocked). However, there have been no studies demonstrating a correlation between TBI and stroke.
TBI occurs when external forces (impact, crush, concussion) disrupt normal brain function. In the United States alone, 1 in 53 people suffer such injuries each year. Worldwide, TBI is a leading cause of physical disability, social disruption, and death.
Using data from a national Taiwanese database, the researchers estimated the five-year risk of stroke in patients with TBI. They had information on 23,199 adult patients with head injuries who were treated as outpatients or inpatients from 2001 to 2003. A control group of 69,597 Taiwanese with non-traumatic brain injuries served as controls. The average age of the patients was 42 years, and 54% were men.
Within three months of injury, stroke occurred in 2.91% of patients with traumatic brain injury and only 0.3% of patients with non-traumatic brain injury. It turns out that the rates differ by a factor of ten.
Over time, the risk of stroke in patients with TBI gradually decreased: one year after the injury, it was 4.6 times higher than in the control group, and 2.3 times higher after five years. Those who had suffered a skull fracture were at the highest risk: in the first three months after the accident, they had a stroke 20 times more often than those who had not suffered a fracture.
In addition, patients with TBI were found to have a significantly increased risk of hemorrhage - subarachnoid (bleeding in the space between the arachnoid and pia mater) and intracerebral (bleeding in the brain caused by a ruptured blood vessel).
After the researchers controlled for the subjects' age and gender, they found that patients with TBI were more likely to have hypertension, diabetes, coronary artery disease, atrial fibrillation, and heart failure.
Taken together, these findings demonstrate the need for intensive medical monitoring and regular magnetic resonance imaging of the brain in patients with TBI, especially in the first few months after injury.
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