Improving diagnosis and treatment of brain injury in survivors of intimate partner violence

Fraser Health’s Embrace Clinic is part of a $3.4 million U.S. Department of Defence study aimed at improving diagnosis of brain injury in survivors of intimate partnership violence. UBC is leading this important research, which will also explore possible connections to Alzheimer’s disease and related dementias.

“The injuries are unique to each individual,” says Lindsay, a recent client of Embrace Clinic. “It wasn’t until I went to Embrace Clinic that someone also explained the effects of strangulation on the brain. I was strangled many times and it was a real eye opener to hear about the effects of that. I can’t help but feel like there are a lot of other women who may not be aware of this.”

“I am incredibly proud of the work we do to support clients like Lindsay at Embrace Clinic,” says Jennifer Ehirchiou, a Forensic Nurse Practitioner.

Embrace Clinic is part of Fraser Health’s Forensic Nursing Service and a health care response to violence. Services provided by Embrace Clinic typically include medical care, screening and treatment of injuries and infections, providing emergency contraception (including IUD insertions), pregnancy testing, vaccinations, blood and urine tests, prescriptions and referrals to specialists and community resources as needed.

Given the prevalence of strangulation in interpersonal violence, a Strangulation Clinic has been offered at Embrace Clinic since 2022.

“A woman who is strangled by her domestic partner is at 700 times more risk to be killed by her partner in the future and that is profound,” says Hannah Varto, a Forensic Nurse Practitioner and co-founder of Embrace Clinic.

Varto was part of a retrospective chart review of 205 Embrace Clinic clients which found that women experiencing strangulation were 2.24 times more likely to report brain-injury related symptoms compared to those who reported no strangulation. The review concluded that survivors of intimate partner violence are prone to brain injury, and early screening and management of brain injury are warranted.

“Strangulation has not been studied extensively,” says Varto. “It doesn’t happen in sports like concussion does, so we don’t have the same body of research to help inform clinical practice. “

Nurse Practitioners Varto and Ehirchiou are hopeful new research will lead to better diagnosis and treatment of brain injury for clients like Lindsay and all survivors of intimate partner violence.