
Stroke is a medical emergency that occurs when blood flow to the brain is cut off, causing brain cells to die. A broken bone can lead to a stroke, as it increases the risk of falling and bone loss, which can cause a blockage in blood flow to the brain. Additionally, a broken bone can cause a build-up of pressure in the muscles, leading to permanent muscle and nerve damage, which can also lead to a stroke. Furthermore, the psychological distress and physical inactivity that may follow a broken bone can increase the risk of a stroke. It is important to seek medical attention immediately if one experiences any symptoms of a stroke, as early treatment can save lives and increase the chances of a full recovery.
Characteristics | Values |
---|---|
Risk factors for bone fracture | Uncontrolled diabetes, excessive alcohol intake, diet high in saturated fat, trans fat, and cholesterol, carotid or coronary artery disease, oral estrogen therapy, gender, race, family history of stroke, a history of migraine headaches, COVID-19 infection |
Symptoms of bone fracture | Inability to move a part of the body, bruising or discoloration, a deformity or bump that’s not usually on your body |
Types of bone fracture | Transverse fractures, longitudinal fractures, greenstick fractures, comminuted fractures, segmental fractures, stress fractures, buckle fractures, compression fractures, chauffeur fractures, metacarpal fractures, acetabular fractures, growth plate fractures, tibia and fibula fractures, calcaneal stress fractures, fifth metatarsal fractures, trimalleolar fractures |
Treatment for bone fracture | Splinting, casting, closed reduction, internal fixation, external fixation, arthroplasty, bone grafting |
Complications of bone fracture treatment | Acute compartment syndrome, malunion, nonunion, bone infection, other internal damage |
Risk factors for stroke | High blood pressure, diabetes, high cholesterol, irregular heartbeat, osteoporosis, smoking |
Symptoms of stroke | Weakness or numbness of the face, arm, or leg on one side of the body, loss of vision, loss of speech, severe headache, loss of balance, partial or total loss of any senses, confusion or agitation, memory loss, passing out or fainting |
What You'll Learn
- Stroke and bone fracture share common risk factors, such as hypertension and diabetes mellitus
- Stroke is a devastating complication of bone fracture
- Stroke patients are more likely to experience bone fractures due to loss of balance and mobility
- Bone fracture patients with post-fracture stroke have poor functional recovery
- Treatment options for stroke patients with fractures are limited
Stroke and bone fracture share common risk factors, such as hypertension and diabetes mellitus
In addition to these shared risk factors, the impact of bone fracture on stroke recovery has been a subject of recent research. Bone fracture is a common health problem that can cause long-term disability and is a devastating complication of stroke, with patients requiring more care in the first year after a fracture than those without. The incidence of stroke after bone fracture is rare, but the impact of bone fracture occurring before or after a stroke can exacerbate brain injuries and behavioural dysfunction. Animal studies have shown that bone fracture shortly before or after an ischemic stroke increases infarct volume, behavioural deficits, and neuroinflammation. Furthermore, the impact of bone fracture on stroke recovery is influenced by the timing of the fracture in relation to the stroke.
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Stroke is a devastating complication of bone fracture
Stroke is a serious medical condition that occurs when blood flow to the brain is cut off, resulting in brain cell death. It is the fifth leading cause of death in the United States and a leading cause of disability. Bone fractures, on the other hand, are common injuries that can affect anyone at any age and are typically caused by traumas such as falls, car accidents, or sports injuries. While these two conditions may seem unrelated, recent studies have shown that there is a link between them, with bone fractures being a potential cause of strokes.
The Link Between Bone Fractures and Strokes
Research has found that individuals who have suffered a bone fracture are at an increased risk of experiencing a stroke. A study from Taiwan showed that patients with a broken hip had a more than 50% increased risk of having a stroke within a year of their injury compared to similar patients without fractures. This suggests that there may be a connection between bone fractures and strokes, but the underlying reasons for this link are not yet fully understood.
Risk Factors and Complications
Both stroke and bone fractures share some common risk factors, such as hypertension and diabetes mellitus. Additionally, individuals with osteoporosis, a condition that weakens bones, are at a higher risk of experiencing bone fractures, which can then lead to a stroke. The complications of a stroke can further increase the risk of bone fractures. Stroke survivors often experience a loss of balance and mobility, making them more prone to falls and, consequently, bone fractures.
Treatment and Prevention
The treatment for strokes involves the use of medicines to break up blood clots and prevent new clots from forming. Procedures such as thrombectomy, angioplasty, and stenting are also used to open up blocked arteries and improve blood flow to the brain. Similarly, bone fractures may require surgery, especially if the bones are severely displaced or if there is an open fracture where the bone breaks through the skin.
To reduce the risk of strokes and bone fractures, individuals can make lifestyle changes such as maintaining a healthy diet, exercising regularly, and controlling risk factors like high cholesterol, diabetes, and high blood pressure. Additionally, individuals who have experienced a stroke or bone fracture should work closely with their healthcare providers to monitor their recovery and manage their risk factors to prevent further complications.
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Stroke patients are more likely to experience bone fractures due to loss of balance and mobility
Motor changes, including posture, mobility, and balance post-stroke contribute to bone loss and thus increase the risk of bone fracture. Balance and mobility performance do not significantly explain falls, but falls-related self-efficacy is a significant determinant of falls.
Balance and mobility can be assessed using the Berg Balance Scale (BBS) and the Timed Up and Go Test (TUG). The BBS is a 14-item assessment tool that evaluates the ability to balance in a variety of postures, while the TUG test measures the time it takes to rise from a chair, walk a short distance, turn, and sit down again.
To prevent bone fractures, stroke patients should focus on improving their balance and mobility through physical rehabilitation and exercise. Additionally, vitamin D and calcium supplementation may be recommended to improve bone health.
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Bone fracture patients with post-fracture stroke have poor functional recovery
Stroke is one of the most devastating complications of bone fracture, occurring in up to 4% of patients after surgical repair for hip fracture. Bone fracture and ischemic stroke have many common risk factors. The impact of bone fracture on stroke recovery has not drawn much attention in the research field. Bone fracture could occur in stroke patients at different times during the recovery phase.
The overall number of hip fractures is high and is anticipated to exceed 6 million a year. The lifetime risk of hip fracture is 17.5% for women and 6% for men. Hip fracture patients are at a 1.54-fold higher risk of developing stroke than controls. The estimated occurrence of stroke after hip fracture is 64,600 per year.
Stroke and bone fracture share some common risk factors, such as hypertension and diabetes mellitus. Management of these risk factors to prevent stroke or bone fracture is complicated. For example, using pioglitazone to treat insulin-resistant non-diabetes patients who have a history of stroke reduced the risk of stroke, but increased the risk of bone fracture.
Animal studies have shown that bone fracture shortly before or after ischemic stroke exacerbates stroke injuries. Mice that had tibia fracture 6 h before, one day before, or one day after the permanent occlusion of the distal middle cerebral artery had more severe behaviour deficits than mice subjected to occlusion alone. They took a longer time to remove the adhesive on the fore paw opposite to the stroke side in the adhesive removal test, and made more turns to the stroke side during the corner test. The mice with bone fracture and occlusion have larger infarct volumes and more apoptotic neurons in the peri-infarct region than mice with stroke alone.
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Treatment options for stroke patients with fractures are limited
Stroke is a life-threatening medical condition that requires immediate attention and treatment. It occurs when the blood flow to the brain is blocked or disrupted, causing brain cells to die due to oxygen deprivation. As a leading cause of death and disability, prompt treatment is crucial to reducing damage and preventing future strokes. However, the treatment options for stroke patients who also have fractures are limited.
Intravenous thrombolysis is currently the most widely accepted treatment for acute ischemic stroke and is the only therapy approved by the U.S. Food and Drug Administration (FDA). This treatment involves administering tissue plasminogen activator (tPA), a "clot-busting" drug, to break up blood clots. However, tPA must be given within a narrow time window of 3 hours after the onset of stroke symptoms to be effective. Beyond this window, the use of tPA may lead to hemorrhagic transformation, increasing morbidity and mortality.
For individuals who do not receive thrombolysis, antiplatelet or anticoagulation therapy is recommended to reduce the risk of recurrent strokes. However, these therapies can increase the risk of fracture hemorrhage, and there are no clear guidelines on the use of antithrombotic drugs after a fracture. This limitation highlights the complex interplay between stroke and bone fracture, which share common risk factors such as hypertension and diabetes mellitus.
The impact of bone fracture on stroke recovery has not received sufficient attention, and there is currently no optimal strategy for preventing or treating post-stroke bone fracture or post-bone fracture stroke. While some studies have suggested that certain drugs, such as pioglitazone, can reduce the risk of stroke, they may simultaneously increase the risk of bone fracture. This complexity underscores the need for a deeper understanding of the underlying mechanisms connecting these two conditions.
Animal studies have provided valuable insights into the effects of bone fracture on stroke recovery. These studies indicate that bone fracture before or after an ischemic stroke can exacerbate stroke injuries, leading to larger infarct volumes, increased neuronal death, and more severe behavioral deficits. Additionally, bone fracture enhances inflammation in the peri-infarct areas, with higher levels of inflammatory markers and increased infiltration of immune cells.
While there is no established therapeutic strategy to prevent stroke in bone surgery patients, some studies suggest that inhibiting specific inflammatory pathways may be a promising approach. For example, targeting high-mobility group box 1 protein (HMGB1), a key mediator of the inflammatory response to trauma, has shown potential in reducing brain injury and improving recovery. Similarly, modulating the cholinergic anti-inflammatory pathway by activating the α7 nicotinic acetylcholine receptor (α7 nAChR) has been found to reduce brain damage and improve recovery in stroke patients with bone fractures.
In summary, the limited treatment options for stroke patients with fractures underscore the need for further research to develop innovative therapies. Understanding the underlying mechanisms of the interplay between stroke and bone fracture is crucial for improving patient outcomes and reducing the burden on healthcare resources.
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Frequently asked questions
A stroke occurs when blood flow to an area in the brain is cut off. The brain cells, deprived of the oxygen and glucose they need to survive, die. If a stroke is not caught early, permanent brain damage or death can result.
The most common symptoms of a stroke are:
- Weakness or numbness of the face, arm, or leg on one side of the body
- Loss of vision or dimming (like a curtain falling) in one or both eyes
- Loss of speech, difficulty talking or understanding what others are saying
- Sudden, severe headache with no known cause
- Loss of balance or unstable walking, usually combined with another symptom
Get familiar with the acronym B.E.F.A.S.T. to learn the signs and symptoms of a stroke and get help quickly:
- B is for balance – a sudden loss of balance
- E is for eyes – vision loss in one or both eyes
- F stands for face – an uneven smile or weakness in the face
- A means arm – weakness in one arm
- S is for speech – words sound slurred
- T means time – call 911 right away if you or someone else has symptoms like these
Controllable risk factors for stroke:
- Uncontrolled diabetes
- Excessive alcohol intake
- Diet high in saturated fat, trans fat, and cholesterol
- Carotid or coronary artery disease
- Oral estrogen therapy, including hormone replacement therapy (HRT) and birth control pills
Uncontrollable risk factors for stroke:
- Gender (men have more strokes, but women have deadlier strokes)
- Race (African American people have a higher risk)
- Family history of stroke
- A history of migraine headaches
A broken bone can cause a stroke due to the increased risk of falling and breaking bones, as well as the sedentary lifestyle that often follows a broken bone.