Korean J Neurotrauma.  2014 Oct;10(2):35-40. 10.13004/kjnt.2014.10.2.35.

Cerebral Infarction after Traumatic Brain Injury: Incidence and Risk Factors

Affiliations
  • 1Department of Neurosurgery, Hanyang University Medical Center, Seoul, Korea. hjyi8499@hanyang.ac.kr

Abstract


OBJECTIVE
Post-traumatic cerebral infarction (PTCI) is one of the most severe secondary insults after traumatic brain injury (TBI), and is known to be associated with poor outcome and high mortality rate. We assessed the practical incidence and risk factors for the development of PTCI.
METHODS
We conducted retrospective study on 986 consecutive patients with TBI from the period May 2005 to November 2012 at our institution. The definition of PTCI was made on non-enhanced CT scan based on a well-demarcated or fairly discernible region of low attenuation following specific vascular territory with normal initial CT. Clinical and radiological findings that related to patients' outcome were reviewed and statistically compared.
RESULTS
PTCI was observed in 21 (2.1%) patients. Of various parameters, age (p=0.037), initial Glasgow coma scale score (p<0.01), brain herniation (p=0.044), and decompressive craniectomy (p=0.012) were significantly higher in patients with PTCI than patients who do not have PTCI. Duration between accident and PTCI, patterns of TBI and vascular territory of PTCI were not specific. The mortality rates were significantly higher in patients with PTCI than without PTCI.
CONCLUSION
The development of PTCI is rare after TBI, but it usually results in serious outcome and high mortality. Early recognition for risks and aggressive managements is mandatory to prevent PTCI.

Keyword

Cerebral infarction; Craniocerebral trauma; Brain injuries; Glasgow coma scale; Hernia; Decompressive craniectomy

MeSH Terms

Brain
Brain Injuries*
Cerebral Infarction*
Craniocerebral Trauma
Decompressive Craniectomy
Glasgow Coma Scale
Hernia
Humans
Incidence*
Mortality
Retrospective Studies
Risk Factors*
Tomography, X-Ray Computed

Figure

  • FIGURE 1 Computerized tomography shows a post-traumatic cerebral infarction. A: Right posterior cerebral artery territory after ipsilateral epidural hematoma removal. B: Traumatic subarachnoid hemorrhage with post-traumatic cerebral infarction on the left middle cerebral artery territory. C: Post-traumatic cerebral infarction on the right anterior choroidal artery territory.


Cited by  2 articles

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Korean J Neurotrauma. 2015;11(2):112-117.    doi: 10.13004/kjnt.2015.11.2.112.

Clinical Outcome of Acute Epidural Hematoma in Korea: Preliminary Report of 285 Cases Registered in the Korean Trauma Data Bank System
Young Ha Jeong, Ji Woong Oh, Sungmin Cho,
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