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Craig Hospital/CDC Study Published in Stroke Finds Tenfold Higher Stroke Risk in TBI Patients

Study led by Craig Hospital with the U.S. Centers for Disease Control and Prevention finds the rate of stroke incidence 10 times higher in patients with traumatic brain injury

Englewood, Colo. – (July 20, 2017) – The findings from a groundbreaking study conducted by researchers at Craig Hospital—a world-renowned rehabilitation hospital and research center that specializes in the care of people who have sustained a spinal cord and/or a brain injury—along with the U.S. Centers for Disease Control and Prevention (CDC), have been published in the latest edition of the American Heart Association’s journal, Stroke. The study, titled “Acute Ischemic Stroke After Moderate to Severe Traumatic Brain Injury: Incidence and Impact on Outcome” found that many individuals who experience a traumatic brain injury (TBI) also suffer an acute stroke at the time of injury.

The study is the first to evaluate and characterize the risk factors and incidence of acute ischemic stroke (AIS) in the hours or days immediately after experiencing a TBI, and its role in outcome for these severely injured patients.

“The findings of this investigation are potentially important for patients who present initially with brain trauma but quickly develop stroke that may not immediately be recognized,” said Robert Kowalski, MD, MS, principal investigator at Craig Hospital, who led the stroke research project. “This is particularly true in younger patients, for whom a stroke suspicion may be low in the emergency department setting, but for whom a stroke may cause lifelong deficits.”

In this research collaboration between the CDC and the Traumatic Brain Injury Model Systems (TBIMS) program, and led by Craig Hospital, investigators studied more than 6,400 patients who sustained a TBI over a seven-and-a-half-year period.

Research showed that the frequency of AIS following TBI was 10 times higher than the rate of AIS in the general population.

In addition, among survivors of moderate to severe TBI who were admitted for acute treatment and subsequent inpatient rehabilitation, 2.5 percent had onset of AIS during the hours and days of initial hospitalization after brain trauma. Half of the TBI patients with concurrent acute stroke were age 40 years or younger.

“With this work, we better understand how to prevent complications at the time of brain injury, especially for younger adults,” said Juliet Haarbauer-Krupa, PhD, study co-author and senior health scientist at CDC’s Injury Center. “These findings also reinforce how important it is to be vigilant for evidence of stroke at the time of injury so that we can improve outcomes for people with TBI.”

Dr. Haarbauer-Krupa added that with TBI causing 300,000 hospitalizations and 50,000 deaths yearly, understanding effective interventions can interrupt the debilitating impact of TBI and stroke.

The full study can be found on the Stroke website.


About Craig Hospital

Craig Hospital is a world-renowned, 93-bed, private, not-for-profit rehabilitation hospital and research center that specializes in the care of people who have sustained a spinal cord and/or a brain injury. Craig provides a comprehensive system of inpatient and outpatient medical care, rehabilitation, neurosurgical rehabilitative care, and long-term follow-up services. Half of Craig's patients come from outside of Colorado. Craig has been ranked as a top 10 rehabilitation center by U.S. News and World Report for 27 consecutive years. Craig has received the NDNQI® award in 2009, 2012, 2013, 2014 and 2015 for the highest quality outcomes in nursing care in a rehabilitation facility. Craig was voted by employees as a "Top Work Place" by the Denver Post for the past three years, and was ranked in the top 150 places to work in healthcare by Becker's Healthcare in 2014.

About CDC’s National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention

For more than 20 years, the Injury Center has helped protect Americans from injuries and violence. As the nation’s leading authority on injury and violence, we study violence and injuries, research the best ways to prevent them, and apply science and create real-world solutions to keep people safe, healthy, and productive. Within the Division of Unintentional Injury Prevention, it is part of our mission to reduce deaths and injuries from traumatic brain injury (TBI). Our work informs how to protect people from TBIs, help medical professionals improve TBI treatment, and support state TBI surveillance and prevention efforts. For more information, visit