Distant sequelae of traumatic brain injury: premature mortality and intracranial neoplasms.

OBJECTIVE

Determine the relationship between traumatic brain injury (TBI) and premature mortality and intracranial neoplasms occurring 6 months or more after TBI.

PARTICIPANTS

Not applicable.

DESIGN

Systematic review of the published, peer-reviewed literature.

PRIMARY MEASURES

Not applicable.

RESULTS

We identified 23 studies that examined premature mortality following TBI and 16 that addressed intracranial neoplasms. There was clear evidence of an association between penetrating brain injury and premature mortality among patients surviving at least 6 months; and similarly compelling evidence of an association between moderate or severe TBI and premature mortality among patients injured severely enough to require acute rehabilitation. There was inadequate evidence to reach a conclusion about whether other closed head injuries were associated with premature mortality. For intracranial neoplasms, there was an apparent association between TBI and intracranial neoplasms diagnosed within 1 year following TBI; however, these tumors were likely incidentally found during evaluation for the TBI. For tumors diagnosed more than 1 year post injury, the evidence was inadequate to conclude that there was an association, although at least 1 very large registry-based study found a borderline association.

CONCLUSION

More severe TBI (ie, penetrating and moderate and severe TBI requiring rehabilitation) is associated with premature mortality among patients surviving at least 6 months. There is no clear evidence for an association between TBI and intracranial neoplasms presenting more than 1 year following TBI.