Risk Factors for Cerebral Infarction After Moderate or Severe Traumatic Brain Injury

Abstract

Purpose: Posttraumatic cerebral infarction (PTCI) is a common and relatively serious complication of traumatic brain injury (TBI) without a clear etiology. Evaluating risk factors in advance is particularly important to predict and avoid the occurrence of PTCI. Patients and Methods: We retrospectively analyzed 297 patients with moderate to severe TBI admitted to the Department of Neurosurgery in our hospital from January 2019 to September 2020 and evaluated the effects of various factors such as age, sex, admission Glasgow Coma Scale (GCS), skull base fracture, subarachnoid hemorrhage (SAH), brain herniation, hypotensive shock, and decompressive craniectomy on the incidence of PTCI. We also performed a multivariate logistics regression analysis on the relevant factors identified and evaluated the diagnostic value of each risk factor in advance by receiver operating characteristic (ROC) analyses. Results: Among the patients, 32 (10.77%) suffered PTCI. The incidence rates of PTCI in those with GCS scores of 3-8 and 9-12 were 15.87% (30/189) and 1.85% (2/108), respectively, while the rates were 18.84% (13/69), 15.03% (29/193), 18.57% (13/70), and 20.59% (14/68) in those with skull base fractures, traumatic SAH, brain herniation, and hypotensive shock, respectively, and 14.38% (23/160) in those who underwent decompressive craniectomy. These differences in PTCI incidence were statistically significant. However, the differences in PTCI incidence caused by patient age and sex were not statistically significant. Conclusion: Low GCS score, skull base fractures, traumatic SAH, brain herniation, hypotensive shock, and decompressive craniectomy are risk factors for the occurrence of PTCI, while age and sex are not significantly correlated with the occurrence of PTCI.

The Risk Factors for Massive Cerebral Infarction Secondary to Epidural Hematoma Caused by Brain Trauma in Children

“…(2) The proportion of body uid loss in children with brain trauma is signi cant, rendering them highly susceptible to shock, especially when combined with other trauma, which further aggravates the hypoperfusion 14 . Some scholars believe that hypoperfusion is an important cause of cerebral ischemia, which is also consistent with clinical experience 15 . (3) tSAH can lead to vasospasm and cerebral ischemia in children.…”

Cerebral infarction following administration of andexanet alfa for anticoagulant reversal in a patient with traumatic acute subdural hematoma

“…[ 9 , 13 , 47 ] The incidence of posttraumatic cerebral infarction (PTCI) is approximately 10%. [ 43 , 49 ] The mechanisms of PTCI include embolism, hypercoagulable state, vascular compression, vasospasm, and blunt cerebrovascular injury. [ 14 , 49 , 50 ]…”

“…[ 43 , 49 ] The mechanisms of PTCI include embolism, hypercoagulable state, vascular compression, vasospasm, and blunt cerebrovascular injury. [ 14 , 49 , 50 ]…”

“…[9,13,47] e incidence of posttraumatic cerebral infarction (PTCI) is approximately 10%. [43,49] e mechanisms of PTCI include embolism, hypercoagulable state, vascular compression, vasospasm, and blunt cerebrovascular injury. [14,49,50] PTCI of the occipital lobe is well described and often results from compression of the posterior cerebral artery against the tentorium by the herniating medial temporal lobe.…”

“…[43,49] e mechanisms of PTCI include embolism, hypercoagulable state, vascular compression, vasospasm, and blunt cerebrovascular injury. [14,49,50] PTCI of the occipital lobe is well described and often results from compression of the posterior cerebral artery against the tentorium by the herniating medial temporal lobe. Middle cerebral artery territory infarcts may occur as a result of displacement from mass lesions and herniation as well.…”