Does Brain Injury cause brain tumors?

[Wise Young]

This is an older answer that I had posted:

Traumatic Brain Injury and Brain Tumors

Wise Young, Ph.D., M.D.
W. M. Keck Center for Collaborative Neuroscience
Rutgers University, Piscataway New Jersey, 08854

"At the time of my injury I also suffered a head injury that left me in a coma for a week. The head injury left probably a one inch by one inch indention in my head that is probably a 1/16 or less, not sure. My question is whether an injury to the head such as mine increases the chances of a brain tumor? I think that I have read something regarding that and was just curious. My wife had our first baby last month and I was thinking today how important it is now to stay healthy and alive for my wife and boy."
Sebastiang,

I understand your concern. I don't believe that brain injury causes tumors in a vast majority of people. There have been occasional reports of people who have developed brain tumors at the site of the brain injury. However, it is not clear whether these people already had a disposition to have brain tumors and the injury simply aggravated that predisposition. Published population-based studies suggest that people with brain injuries do not have a higher risk of having brain injury than people who have not had such injuries.

To prove that brain injury caused the tumor, we need definitive evidence that brain tumor was not present before the injury. That evidence is seldom available. Brain injury is so prevalent, i.e. so many people have had a history of a bump on the head sufficient to cause a period of unconsciousness, that one would expect that a significant fraction of people who develop brain tumors to have had a history of brain injury. We also don’t have complete followup data on large populations of people who have had brain injury.

I summarize below several recent studies on the subject. Salvati, et al. (2004) reported four cases of “post-traumatic glioma” and reviewed the literature on the subject. All four cases involved brain gliomas developing from the site of an old brain injury and were not observed at the time of injury. Thus, this suggests that it can happen but the data does not give a clear idea of how prevalent it is. Magnavita, et al. (2003) reported a case of a man who suffered severe injury and then developed a glioma at the site of the injury. However, Nygren, et al. (2001) published the largest population-based cohort study on the subject. They established complete followup of 311,006 Swedish patients and found 281 cases of brain tumors. Detailed analyses showed no significant association of brain tumors with traumatic head injury.

In summary, the risk of brain tumors after brain injury is too small to be detected on large-scale population analyses. On the other hand, there have been several cases of people who have developed brain tumors at their injury site. Given this situation, it is probably prudent to get regular MRI scans of your brain every two years. Other than that, I would not worry about it. It is entirely possible that the people who did develop a brain tumor at the site of their injury would have developed tumors anyway but the injury may have aggravated that tendency.

Wise.

References Cited

1. Salvati, M, Caroli, E, Rocchi, G, Frati, A, Brogna, C and Orlando, ER (2004). Post-traumatic glioma. Report of four cases and review of the literature. Tumori. 90: 416-9. Department of Neurosurgery, INM Neuromed IRCCS, Pozzilli, Italy. salvati.maurizio@libero.it. AIMS AND BACKGROUND: To add a further contribution to the literature supporting the relationship between previous head trauma and development of glioma. METHODS: We report on four patients who developed brain gliomas in the scar of an old brain injury. RESULTS: All cases fulfilled the widely established criteria for brain tumors of traumatic origin. In all of our cases there was radiological evidence of absence of tumor at the time of the injury. CONCLUSIONS: We believe that in specific cases it is reasonable to acknowledge an etiological association between a severe head trauma and the development of a glioma. This assumption is further sustained if there is radiological and surgical documentation of the absence of neoplasia at the moment of the trauma.
2. Magnavita, N, Placentino, RA, Mei, D, Ferraro, D and Di Trapani, G (2003). Occupational head injury and subsequent glioma. Neurol Sci. 24: 31-3. Institute of Occupational Medicine, Catholic University School of Medicine, Rome, Italy. We report the case of a policeman who suffered a severe head injury to the right temporoparietal lobe while driving a police car. Four years later, the patient developed a neoplasm at the precise site of the meningocerebral scar. Histological examination confirmed a glioblastoma multiforme adjacent to the dural scar. Radiological documentation of the absence of tumor at the time of injury, exact localization of the neoplasm in the injured cerebral area, and latency of the cancer supported the hypothesis of a causal relationship with brain trauma. Physicians faced with brain neoplasms in adults should carefully investigate the patient's personal history of head trauma. When a relationship with occupational head injury is probable, reporting of suspect occupational illness is compelling.
3. Nygren, C, Adami, J, Ye, W, Bellocco, R, af Geijerstam, JL, Borg, J and Nyren, O (2001). Primary brain tumors following traumatic brain injury--a population-based cohort study in Sweden. Cancer Causes Control. 12: 733-7. Department of Rehabilitation Medicine, Karolinska Institute, Danderyd Hospital, Stockholm, Sweden. catharina.nygren@mbox304.swipnet.se. OBJECTIVES: The aim of this study was to explore the association between traumatic brain injury and brain tumor development. METHODS: A cohort of patients hospitalized for traumatic brain injury during 1965-1994 was compiled using the Swedish Inpatient Register. Complete follow-up through 1995 was attained through record linkage with the Swedish Cancer Register, the Cause of Death Register, and the Emigration Register. Standardized incidence ratios (SIRs), defined as the ratios of the observed to the expected numbers of brain tumors, were used as the measure of relative risk. The expected number of brain tumors was calculated by multiplying the observed person-time by age-, gender- and calendar year-specific incidence-rates derived from the general Swedish population. RESULTS: The cohort included 311,006 patients contributing 3,225,317 person-years. A total of 281 cases of brain tumors were diagnosed during follow-up. No associations were found between traumatic brain injury and the risk of primary brain tumors, neither overall (SIR: 1.0; 95% confidence interval (CI): 0.9-1.2), nor in analyses broken down by main groups of brain tumors. Stratified analyses according to age at entry into the cohort, year of follow-up, and severity of the brain injury all showed essentially the same null results. CONCLUSION: No association between traumatic head injury and primary brain tumors has been found.

[SCI-Nurse]

Thanks, Dr. Young. I do know that a previous brain injury does increase your risk for Alzheimer's though, so this is something that people should be aware of.

(KLD)

[skippy13]

As to brain injury being correlated to a higher risk of alzheimers...

Does this include athletes and others who have suffered repeated assaults to the brain in the form of concussions? My son was an extreme mountain biker and has had numerous concussions. I worry about him even though he seems fine now.

How about the possibility of parkinsons like syndromes like Muhammed Ali? Does the repeated concussions and hits to the head actually increase the incidence of Parkinsons or is it a parkinsons like syndrome?

[Wise Young]

As to brain injury being correlated to a higher risk of alzheimers...

Does this include athletes and others who have suffered repeated assaults to the brain in the form of concussions? My son was an extreme mountain biker and has had numerous concussions. I worry about him even though he seems fine now.

How about the possibility of parkinsons like syndromes like Muhammed Ali? Does the repeated concussions and hits to the head actually increase the incidence of Parkinsons or is it a parkinsons like syndrome?

Parkinsonian symptoms are one of the outcomes of dementia pugilistica, a type of neurodegenerative disease that affects amateur or professional boxes as well as athletes that participate in other sports that subject the brain to repeated concussions. Other names include "boxer's encephalopathy", "punch-drunk syndrome", and "chronic traumatic brain injury associated with boxin (CTBI-B). The symptoms develop over many years and show up 12-16 years after the start of a boxing career and may affect as many as 15-20% of boxers.
http://en.wikipedia.org/wiki/Dementia_pugilistica

[Sebastiang]

SCI-Nurse, do you have any reports/articles the detail the correlation between head injuries and dementia? I think that I may be screwed because father has early stages and I have the head injury.
Thanks

[Wise Young]

SCI-Nurse, do you have any reports/articles the detail the correlation between head injuries and dementia? I think that I may be screwed because father has early stages and I have the head injury.
Thanks

Sebastiang,

There is a high correlation between head injury and dementia, particularly repeated head injury. There is a condition called dementia pugilistica that frequently occur to boxers who have been repeatedly hit in the head. A condition called frontotemporal dementia has been linked to blast injuries.

Several recent reports have claimed that head injury increases the risk of dementia. For example, a recent NIH-DOD funded study by Kristine at al.claims that even a concussion can put a person at risk of getting dementia [source]http://www.huffingtonpost.com/2011/07/18/brain-injury-dementia-risk_n_901512.html[/source]. The study reviewed the records of 281,540 veterans and found 4,902 who had suffered traumatic brain injury. Of these, 15% eventually developed dementia, compared to 7% of the others.

The study has several flaws in its interpretation of the data. First, the study did not evaluate the possibility that those with early dementia or family history of dementia may be more accident prone and at risk of brain injury. Second, the study did not consider the possibility that head injury compromises the ability of the brain to compensate of neurodegeneration with aging and therefore increases the likelihood of earlier appearance of dementia. Third, veterans with brain injuries may be investigated and followed more closely, and family members may be more sensitive to symptoms of dementia.

Wise.

[metronycguy]

ive seen punch drunk bboxing coaches in some of the old timers trying to make a living teaching boxing at local community colleges, very sad.
The NFL has a player supported ongoing study, where they will their brain to be quickly autopsied by docs who are looking for abnormalities. Most of the deceased players are relatively young.
the old-time players who really are not that old are already feeling the effects of years getting' hit in the head and the current helmets do nothing to stop concussions

[RMitchell51485]

Can a concussion cause 5 brain lesions a year later

Ok, here is my question, my husband was just diagnosed as having 5 5mm brain lesions. He has been experiencing a sever headache for 61 days now, nausea, vomitting, double vision, vertigo, memory loss. I am very worried about him. We had been told that the lesions may be caused by a concussion that was mild a year ago. I am not so sure that that is possible. He told me today that he feels like he needs to be admitted.We are grasping at strings for answers. Here in KY the doctors are not the most forthcoming on answers as to whats going on. I would love to hear a doctors thoughts on what could possibly be causing this. We were told it could be MS but he had a spinal tap done and it was clear. So we are so stressed over what is happening.

[RememberingmyFather]

In my Father's case yes

My Father was enlisted in the US Marine Corps in 1975 on the "Buddy System" with my Uncle, somewhere around the ending of his boot camp in 1976 (at least that is what I am told) my Father being lined up with other soldiers was "hazed" by his sargent and told to "Drop and give me 50" while attempting to complete this task on the third push up his sargent reached down grabbed my Father by the shoulders and kneed him in his forehead... initially my Father attempted to shake the incident off but was according to my Uncle a little dizzy, the next morning he woke up blind... he was sent to an offsite hospital where x-rays showed he had a crack in his frontal skull area right between the eyes he was still blind and remained in that state for three days; following regaining his sight he began to have horrible headaches daily the pain progressed as the days went by. Eventually he was honorably discharged and sent home when he arrived home he had more x-rays taken and it was discovered that the crack had become a gap and tetanus had set in. A few months following he was given another x-ray and it was discovered that a tumor had developed in the area he was hit. Unfortunately no one knew anything about operating on the brain here in Ohio at that time, he was told that eventually he would die but that he should enjoy life; he did just that he and my Mother had me and it was not long after that, that the doctors gave him 3 months to live he did not tell his family but made preparations for his funeral and for me, he died June 10 1981 he was 23 years old. I honor my Father everyday and hope that no one else has to go through what he went through or my family. God bless.

[SCI-Nurse]

A brain injury does not cause cancer. It is a coincidence that the tumor occurred later in the brain, not due to trauma. Just because it happened to someone who had a brain trauma at one time is not proof of causation.

Sorry about your father though, and glad you are remembering him today.

(KLD)

[RememberingmyFather]

Thanks

Thank you for your reply, it is appreciated however after reading your post I did some research and it turns out that not all brain tumors are cancerous and I don't remember stating that he had brain cancer, so I went back thorough my Father's records which took forever to obtain and a lot of fighting with the US Marines and those records which my family had and it turns out that my father did not have a cancerous brain tumor. I also discovered that some brain tumors begin as lesions on the brain and the pressure that is sustained from the lesion being present and the tight enclosed space can cause a tumor to form... a very dangerous tumor at that.

Thanks

[Sebastiang]

http://www.foxnews.com/health/2014/0...tcmp=obnetwork

[Vintage]

Association between traumatic brain injury and the subsequent risk of brain cancer.
...After adjusting for sociodemographic characteristics, the hazard of being diagnosed with malignant brain tumors during the 3-year follow-up period was 4.67 (95% CI: 1.84-11.83) times greater for those who sustained a TBI than for patients in the comparison cohort. In addition, we found an association between TBI severity and malignant brain tumor among patients with TBI (p=0.033). Our findings suggest a positive correlation between TBI and the relatively short-term development of malignant neoplasms of the brain...


https://www.ncbi.nlm.nih.gov/pubmed/22320191

[squid007]

No, that's impossible. However I've read about some cases when the injury was a trigger for the cancer developing. It totally depends on each case

[EricO]

Association between traumatic brain injury and the subsequent risk of brain cancer.
...After adjusting for sociodemographic characteristics, the hazard of being diagnosed with malignant brain tumors during the 3-year follow-up period was 4.67 (95% CI: 1.84-11.83) times greater for those who sustained a TBI than for patients in the comparison cohort. In addition, we found an association between TBI severity and malignant brain tumor among patients with TBI (p=0.033). Our findings suggest a positive correlation between TBI and the relatively short-term development of malignant neoplasms of the brain...


https://www.ncbi.nlm.nih.gov/pubmed/22320191

Quite an eye-opening study. I think it goes a long way to show that TBI might have a role to play in causing or aggravating brain cancer. Quite scary I must say.