Posttraumatic cerebral infarction in patients with moderate or severe head trauma

Marino, Rosella; Gasparotti, Roberto; Pinelli, Lorenzo; Manzoni, D.; Gritti, Paolo; Mardighian, Dikran; Latronico, Nicola

doi:10.1212/01.wnl.0000238081.35281.b5

Cited by 37 publications

(46 citation statements)

References 34 publications

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“…Nonterritorial-nonboundary infarction is single or multi focal lesions without a precise localization. 2,5) Mirvis et al, 6) Server et al 13) and Marino et al 5) found that territorial cerebral infarctions were most common pattern, especially PCA territory infarction, than boundary zone infarction. And cortical infarctions were more common than subcortical infarction.…”

Section: Discussionmentioning

confidence: 98%

“…laceration or dissection), embolism, or injury to cortical vessels with skull fractures. 2,5) Hippocampus, basal ganglia, cerebral cortex, and cerebellum are the most common sites of infarction.…”

Section: Discussionmentioning

confidence: 99%

“…There are few well-established therapies for traumatic brain injury. 5) Owing to the complexity of factors that influence outcome, clinical trials have been difficult to design and conduct. Several trials that have been performed in recent years failed to demonstrate a significant improvement in outcome, despite promising preclinical data.…”

Section: Discussionmentioning

confidence: 99%

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The Multifocal Cerebral Infarctions in Patient after Epidural Hematoma Evacuation

Son

Shin

Chung

et al. 2010

J Korean Neurotraumatol Soc

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We report a patient who developed multiple focal cerebral infarctions after epidural hematoma evacuation. A 41-year-old man presented with altered mentality after sustaining a head trauma. Computer tomography (CT) scan showed large epidural hematoma at the left hemisphere. The patient underwent emergency evacuation of the hematoma and decompression surgery. Three days after the surgery, the patient showed right side hemiparesis. CT and MR diffusion weight images (MRDWI) revealed multiple infarctions at focal posterior cerebral artery (PCA) and middle cerebral artery (MCA) territories and subcortical parenchyma. Several months after the surgery, the patient showed improved mentality, but his cognition and hemiparesis were not improved as much. Before ischemic change occurs, it is vital to administer early, rapid and aggressive management are required to prevent posttraumatic cerebral infarction. ( J Kor Neurotraumatol Soc 2010;6:66-69 ) KEY WORDS: Cerebral infarction·Head trauma·Epidural hematoma.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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The Multifocal Cerebral Infarctions in Patient after Epidural Hematoma Evacuation

Son

Shin

Chung

et al. 2010

J Korean Neurotraumatol Soc

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“…Traumatic brain damage causes important mortality and morbidity rates at all ages [5]. Artery-to-artery emboli or occlusion of craniocervical arteries mostly due to dissection are the most common causes of ischemia after trauma.…”

Section: Discussionmentioning

confidence: 99%

Post-Traumatic Late Onset Cerebral Ischemia

Genç¹

2015

Ann Clin Anal Med

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ÖzetTravma sonrası iskeminin en sık nedeni çoğunlukla diseksiyon nedeniyle ortaya çı-kan arterden artere emboli veya kraniyoservikal arterlerin tıkanmasıdır. 29 yaşın-daki erkek hasta kafa travmasının olmadığı sert paraşütle inişinden sonra 45 dakika süren bilinç kaybı nedeni ile 3 gün önce başka bir hastaneye başvurmuş ve nörolojik muayenesinin ve beyin BT incelemesinin normal olması üzerine 24 saatlik gözlem sonrası taburcu edilmiş. Taburcu olduktan 2 gün sonra epileptik nöbet geçiren hasta hastanemize başvurdu. Nörolojik muayenede sol hemianopi saptanan hastanın çekilen beyin MR incelemesinde sağ oksipital bölgede subakut iskemi saptandı. Romatolojik, kardiyolojik ve vasküler patolojiler dışlandıktan sonra hastaya geç başlangıçlı serebral iskemi tanısı konarak antiödem ve antiepileptik tedavi başlandı. Hasta sol hemianopi ve hafi kognitif bozukluk ile taburcu edildi. Travmayı takiben bilinç kaybı olan hastaların en az 72 saat gözlem altında tutulmasının mantıklı olacağını düşünmekteyiz. Anahtar KelimelerPost-Travmatik Serebral İskemi; Post-Travmatik Epilepsi; Geç Başlangıçlı Epilepsi; Kafa Travması Abstract Artery-to-artery emboli or occlusion of craniocervical arteries mostly due to dissection are the most common causes of ischemia after trauma. A 29 year-old male had been admitted to another hospital with loss of consciousness lasting for about 45 minutes after a hard parachute landing without head trauma three days ago. As his neurological examination and brain CT were normal, he had been discharged after 24 hours of observation. Two days after his discharge, he was admitted to our department with epileptic seizure. His neurological examination revealed left hemianopia. After observing occipital subacute ischemia at right side in brain magnetic resonance imaging (MRI), we performed cerebral angiography and no dissection was observed. Excluding the rheumatologic, cardiologic and vascular events, our final diagnosis was late onset cerebral ischemia. Anti-edema and antiepileptic treatment was initiated. He was discharged with left hemianopia and mild cognitive deficit. We suggest that it will be wise to hospitalize patients for at least 72 hours who has a history of unconsciousness following trauma.

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“…In addition to cerebral herniation, other potential causes of infarction include vasospasm, increased ICP, global hypoxia or hypoperfusion, and compressive ischaemia from intracerebral haematomas. 103 …”

Section: Post-traumatic Cerebral Infarctionmentioning

confidence: 99%

MDCT imaging of traumatic brain injury

Lolli¹,

Pezzullo²,

Delpierre³

et al. 2016

BJR

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The aim of emergency imaging is to detect treatable lesions before secondary neurological damage occurs. CT plays a primary role in the acute setting of head trauma, allowing accurate detection of lesions requiring immediate neurosurgical treatment. CT is also accurate in detecting secondary injuries and is therefore essential in follow-up. This review discusses the main characteristics of primary and secondary brain injuries.

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Posttraumatic cerebral infarction in patients with moderate or severe head trauma

Abstract: The risk of developing posttraumatic cerebral infarction may be higher in patients with intracranial hypertension than in those without. Patients with posttraumatic cerebral infarction may be at increased risk of residual disability.

Cited by 37 publications

References 34 publications

The Multifocal Cerebral Infarctions in Patient after Epidural Hematoma Evacuation

The Multifocal Cerebral Infarctions in Patient after Epidural Hematoma Evacuation

Post-Traumatic Late Onset Cerebral Ischemia

MDCT imaging of traumatic brain injury

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