, Volume 8, Issue 3–4, pp 197–202 | Cite as

Epidemiology of Traumatic Brain Injury and Subarachnoid Hemorrhage

  • José León-Carrión
  • María del Rosario Domínguez-Morales
  • Juan Manuel Barroso y Martín
  • Francisco Murillo-Cabezas


Incidence rates of traumatic brain injury are high in both industrialized and non-industrialized countries and have been estimated variously to be between 150–250 cases per 100,000 population per year. The estimated incidence rates for subarachnoid hemorrhage (SAH) are between 10 to 25 cases per 100,000 population per year. Seasonal variation in the occurrence of subarachnoid hemorrhage has been reported in studies from different countries, with significant seasonal variations and peak periods for aneurysmal SAH differing widely. A differential racial distribution for SAH has been found as well as a higher mortality rate for women than for men. The cognitive and behavioral consequences of TBI and SAH are significant and affect the quality of life of patients and their families. Recent publications have informed of hypopituitary deficits in patients sustaining TBI or SAH. It is not clear whether the cognitive deficits found in these patients are due to the consequences of the brain injury itself or are related to the hypopituitary deficits. There is a need for research distinguishing the differential cognitive and behavioral effects of the brain injury and the endocrinological deficits in these patients, and for developing adequate treatment.

Key Words

TBI SAH hypopituitarism neuropsychology epidemiology 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Gururaj G. The effect of alcohol on incidence, pattern, severity and outcome from traumatic brain injury. J Indian Med Assoc 2004;102:157–160, 163.PubMedGoogle Scholar
  2. 2.
    de Bruijn SF, Keunen RW. Brain injury in boxers and soccer players; an advisory report from the National Health Council of the Netherlands. Ned Tijdschr Geneeskd 2004;148:2209–2212.PubMedGoogle Scholar
  3. 3.
    Xiang H, Kelleher K, Shields BJ, Brown KJ, Smith GA. Skiing- and snowboarding-related injuries treated in U.S. emergency departments, 2002. J Trauma 2005;58:112–118.PubMedGoogle Scholar
  4. 4.
    Esselman PC, Dikmen SS, Bell K, Temkin NR. Access to inpatient rehabilitation after violence-related traumatic brain injury. Arch Phys Med Rehabil 2004;85:1445–1449.CrossRefPubMedGoogle Scholar
  5. 5.
    Leon-Carrion J, Chacartegi FJ. Blows to the head during development can predispose to violent criminal behaviour: rehabilitation of consequences of head injury is a measure for crime prevention. Brain Injury 2003;17:206–216.Google Scholar
  6. 6.
    Agha A, Rogers B, Sherlock M, O'Kelly P, Tormey W, Phillips J, Thompson CJ. Anterior pituitary dysfunction in survivors of traumatic brain injury. Clin Endocrinol Metab 2004;10:4929–4936.Google Scholar
  7. 7.
    Casanueva FF, Leal A, Koltowska-Haggstrom M, Jonsson P, Goth MI. Traumatic brain injury as a relevant cause of growth hormone deficiency in adults: A KIMS-based study. Arch Phys Med Rehabil 2005;86:463–468.CrossRefPubMedGoogle Scholar
  8. 8.
    Tieves KS, Yang H, Layde PM. The epidemiology of traumatic brain injury in Wisconsin, 2001. WMJ 2005;104:22–55, 54PubMedGoogle Scholar
  9. 9.
    Zygun DA, Laupland KB, Hader WJ, Kortbeek JB, Findlay C, Doig CJ, Hameed SM. Severe traumatic brain injury in a large Canadian health region. Can J Neurol Sci 2005;32:87–92.PubMedGoogle Scholar
  10. 10.
    Adekoya N, Majumder R. Fatal traumatic brain injury, West Virginia, 1989–1998. Public Health Rep 2004;119:486–492.CrossRefPubMedGoogle Scholar
  11. 11.
    Steudel WI, Cortbus F, Schwerdtfeger K. Epidemiology and prevention of fatal head injuries in Germany - trends and the impact of the reunification. Ann Emerg Med 2005;45:37–42.Google Scholar
  12. 12.
    Bahloul M, Chelly H, Ben Hmida M, Ben Hamida C, Ksibi H, Kallel H, Chaari A, Kassis M, Rekik N, Bouaziz M. Prognosis of traumatic head injury in South Tunisia: a multivariate analysis of 437 cases. J Trauma 2004;57:255–261.PubMedGoogle Scholar
  13. 13.
    El-Gindi S, Mahdy M, Abdel Azeem A. Traumatic Brain Injuries in Developing Countries. Road War in Africa. Revista Española de Neuropsicologia 2001;3:3–13.Google Scholar
  14. 14.
    Mateo MA, Glod CA, Hennen J, Price BH, Merrill N. Mild traumatic brain injury in psychiatric inpatients. J Neurosci Nurs 2005 Feb;37:28–33.Google Scholar
  15. 15.
    Ruff R. Two decades of advances in understanding of mild traumatic brain injury. J Head Trauma Rehabilitation 2005;20:5–18.Google Scholar
  16. 16.
    León-Carrión J, Machuca F. Spontaneous recovery of cognitive functions after severe brain injury: when are neurocognitive sequelae established? Revista Española de Neuropsicología, 2001;3:58–67.Google Scholar
  17. 17.
    Leon-Carrion J, De Serdio-Arias ML, Cabezas FM, Roldan JM, Dominguez-Morales R, Martin JM, Sanchez MA. Neurobehavioural and cognitive profile of traumatic brain injury patients at risk for depression and suicide. Brain Inj 2001;15:175–181.PubMedGoogle Scholar
  18. 18.
    Dikmen SS, Bombardier CH, Machamer JE, Fann JR, Temkin NR. Natural history of depression in traumatic brain injury. Arch Phys Med Rehabil 2004;85:1457–1464.CrossRefPubMedGoogle Scholar
  19. 19.
    Vela-Bueno A, Bixler EO, Vgontzas AN. Sleepdisorders in Patients with Traumatic Brain Injury, In J Leon-Carrion, GA Zitney, K von Wilde (eds)Brain Injury Treatment: Theories and Practices, New York: Psychology Press, 2005.Google Scholar
  20. 20.
    Ouellet MC, Savard J, Morin CM. Insomnia following traumatic brain injury: a review. Neurorehabil Neural Repair 2004;18:187–198.PubMedGoogle Scholar
  21. 21.
    Leon-Carrion J, Machuca Murga F, Murga Sierra M, Dominguez-Morales R. Eficacia de programas CRECER de tratamiento intensivo, integral y multidisciplinar de pacientes con traumatismo craneoencefálico valores médico-legales. Revista Española de Neuropsicología 1999;1:49–68.Google Scholar
  22. 22.
    Madrazo-Lazcano M, Machuca-Murga F, Barroso y Martín JM, Domínguez-Morales R, León-Carrion J., Cambios emocionales después de un Traumatismo Craneoencefálico Grave. Revista Española de Neuropsicología 1999;1:75–82.Google Scholar
  23. 23.
    Yamada S, Koizumi A, Iso H, Wada Y, Watanabe Y, Date C, Yamamoto A, Kikuchi S, Inaba Y, Toyoshima H, Kondo T, Tamakoshi A; Japan Collaborative Cohort Study Group. Risk factors for fatal subarachnoid hemorrhage: the Japan Collaborative Cohort Study. Stroke. 2003;34(12):2781–2787.CrossRefGoogle Scholar
  24. 24.
    Anderson CS, Feigin V, Bennett D, Lin RB, Hankey G, Jamrozik K. Australasian Cooperative Research on Subarachnoid Hemorrhage Study (ACROSS) Group (2004). Active and passive smoking and the risk of subarachnoid hemorrhage: an international population-based case-control study. Stroke 2004;35:633–637.Google Scholar
  25. 25.
    Inagawa T. Risk factors for aneurysmal subarachnoid hemorrhage in patients in Izumo City, Japan. Neurosurg 2005;102:60–67.Google Scholar
  26. 26.
    Stegmayr B, Eriksson M, Asplund K. Declining mortality from subarachnoid hemorrhage: changes in incidence and case fatality from 1985 through 2000. Stroke 2004;35:2059–2063.CrossRefPubMedGoogle Scholar
  27. 27.
    Ikawa F, Ohbayashi N, Imada Y, Matsushige T, Kajihara Y, Inagawa T, Kobayashi S. Analysis of subarachnoid hemorrhage according to the Japanese Standard Stroke Registry Study–incidence, outcome, and comparison with the International Subarachnoid Aneurysm Trial. Neurol Med Chir (Tokyo) 2004;44:275–276.CrossRefGoogle Scholar
  28. 28.
    Mitchell P, Hope T, Gregson BA, Mendelow AD. Regional differences in outcome from subarachnoid haemorrhage: comparative audit. BMJ 2004;328:1234–1235.PubMedGoogle Scholar
  29. 29.
    Hamada J, Morioka M, Yano S, Kai Y, Ushio Y. Incidence and early prognosis of aneurysmal subarachnoid hemorrhage in Kumamoto Prefecture, Japan. Neurosurgery 2004;54(1):31–37.Google Scholar
  30. 30.
    Khan FA, Engstrom G, Jerntorp I, Pessah-Rasmussen H, Janzon L. Seasonal patterns of incidence and case fatality of stroke in Malmo, Sweden: the STROMA study. Neuroepidemiology 2005;24:26–31.CrossRefPubMedGoogle Scholar
  31. 31.
    Fischer T, Johnsen SP, Pedersen L, Gaist D, Sorensen HT, Rothman KJ. Seasonal variation in hospitalization and case fatality of subarachnoid hemorrhage - a nationwide danish study on 9367 patients. Neuroepidemiology. 2005;24:32–37.CrossRefPubMedGoogle Scholar
  32. 32.
    Muroi C, Yonekawa Y, Khan N, Rousson V, Keller E. Seasonal variations in hospital admissions due to aneurysmal subarachnoid haemorrhage in the state of Zurich, Switzerland. Acta Neurochir (Wien) 2004;146:659–665.CrossRefGoogle Scholar
  33. 33.
    Schievink WI, Riedinger M, Jhutty TK, Simon P. Racial disparities in subarachnoid hemorrhage mortality: Los Angeles County, California, 1985–1998. Neuroepidemiology 2004;23:299–305.CrossRefPubMedGoogle Scholar
  34. 34.
    Powell J, Kitchen N, Heslin J, Greenwood R. Psychosocial outcomes at three and nine months after good neurological recovery from aneurysmal subarachnoid haemorrhage:predictors and prognosis. J Neurol Neurosurg Psychiatry 2002;75:1119–1124.Google Scholar
  35. 35.
    Mayer SA, Kreiter KT, Copeland D, Bernardini GL, Bates JE, Peery S, Claassen J, Du YE, Connolly ES Jr. Global and domain-specific cognitive impairment and outcome after subarachnoid hemorrhage. Neurology 2002;10(59):1750–1758.Google Scholar
  36. 36.
    Hutter BO, Gilsbach JM, Kreitschmann I. Quality of life and cognitive deficits after subarachnoid haemorrhage. Br J Neurosurg 1995;9:465–475.CrossRefPubMedGoogle Scholar
  37. 37.
    Bjeljac M, Keller E, Regard M, Yonekawa Y. Neurological and neuropsychological outcome after SAH. Acta Neurochir Suppl. 2002;82:83–85.PubMedGoogle Scholar
  38. 38.
    Hutter BO, Kreitschmann-Andermahr I, Gilsbach JM. Cognitive deficits in the acute stage after subarachnoid hemorrhage. Neurosurgery 1998;43:1054–1065.PubMedGoogle Scholar
  39. 39.
    Kreiter KT, Copeland D, Bernardini GL, Bates JE, Peery S, Claassen J, Du YE, Stern Y, Connolly ES, Mayer SA. Predictors of cognitive dysfunction after subarachnoid hemorrhage. Stroke 2002;33:200–208.CrossRefPubMedGoogle Scholar
  40. 40.
    Dombovy ML, Drew-Cates J, Serdans R. Recovery and rehabilitation following subarachnoid haemorrhage: Part II. Long-term follow-up. Brain Inj. 12 1998;10:887–894.Google Scholar
  41. 41.
    Ogden JA, Mee EW, Henning M. A prospective study of impairment of cognition and memory and recovery after subarachnoid hemorrhage. Neurosurgery 1993;33:572–586; discussion 586–587.Google Scholar
  42. 42.
    Hutter BO, Gilsbach JM, Kreitschmann I. Is there a difference in cognitive deficits after aneurysmal subarachnoid haemorrhage and subarachnoid haemorrhage of unknown origin? Acta Neurochir (Wien) 1994;127:129–135.Google Scholar
  43. 43.
    Sonesson B, Saveland H, Ljunggren B, Brandt L. Cognitive functioning after subarachnoid haemorrhage of unknown origin. Acta Neurol Scand 1989;80:400–410.PubMedGoogle Scholar
  44. 44.
    Leon-Carrion J, Alarcón JC, Revuelta M, Murillo-Cabezas F, Domínguez-Roldan JM, Dominguez-Morales MR, Machuca Murga F, Forastero F. Executive Functioning as outcome in patients after traumatic brain injury. Intern J Neuroscience 1998;94:75–83.Google Scholar
  45. 45.
    Hutter BO, Gilsbach JM. Which neuropsychological deficits are hidden behind a good outcome (Glasgow = I) after aneurysmal subarachnoid hemorrhage? Neurosurgery 1993 Dec;33:999–1005.Google Scholar
  46. 46.
    Caeiro L, Menger C, Ferro JM, Albuquerque R, Figueira ML. Delirium in acute subarachnoid haemorrhage. Cerebrovasc Dis 2005;19:31–38.CrossRefPubMedGoogle Scholar
  47. 47.
    Lang CJ, Heidenreich SP, Fahlbusch R, Neundorfer B. Primary loss of consciousness and amnesia in subarachnoid hemorrhage–a quantitative study. Zentralbl Neurochir 2004;65:18–24.PubMedGoogle Scholar

Copyright information

© Springer Science + Business Media, Inc. 2006

Authors and Affiliations

  • José León-Carrión
    • 1
  • María del Rosario Domínguez-Morales
    • 2
  • Juan Manuel Barroso y Martín
    • 1
  • Francisco Murillo-Cabezas
    • 3
  1. 1.Human Neuropsychology Laboratory, Department of Experimental PsychologyUniversity of SevilleSevilleSpain
  2. 2.Center for Brain Injury RehabilitationSevilleSpain
  3. 3.Traumatological Intensive Care UnitHospital Universitatio Virgen del RocioSevilleSpain

Personalised recommendations