Posttraumatic cerebral infarction in severe traumatic brain injury: characteristics, risk factors and potential mechanisms

Abstract

PTCI deteriorates the outcome of sTBI patients. Mechanical compression and hemocoagulative disturbance serve as potential mechanisms mediating this pathophysiological process. PTV may also contribute to PTCI, but its association with PTCI is weak and needs further exploration. Early recognition and intervention of these factors might be beneficial for preventing PTCI.

Impact of a posttraumatic cerebral infarction on outcome in patients with TBI: the Italian multicenter cohort INCEPT study

“…Previous studies were either post-mortem neuropathological investigations or ante-mortem retrospective clinical investigations. Among the latter, the GOS was assessed in four single-center studies at 3 months [5] or 6 months [4,9]; while in one study, the timing of the GOS was not reported [8]. These studies showed increased morbidity [4], increased mortality [9], increased morbidity and mortality [8], or no difference [5] in patients with a PTCI compared with patients without.…”

“…A PTCI is frequent in patients who die after a moderate or severe TBI, with a reported incidence in post-mortem studies up to 90%. The antemortem occurrence rate of a PTCI has been assessed in six single-center studies, of which only one was prospective, and the rate varied between 1.9% and 20.3% [4][5][6][7][8][9]. None of these studies investigated whether PTCI adds incremental value to current prognostic models.…”

Radiologic Findings and Patient Factors Associated with 30-Day Mortality after Surgical Evacuation of Subdural Hematoma in Patients Less Than 65 Years Old

“…In addition, TBI might cause cerebral vascular injury, which leads to ischemic lesions in the brain17). According to a recent study, ischemic stroke is the second most common cause of death for patients with TBI, after decompressive craniectomy14,21). Khoury et al reported that diabetic patients showed a 3- to 4-fold increased incidence rate of ischemic stroke compared with those without diabetes mellitus18).…”

“…Several studies have reported that tSAH was an independent predictor of TBI mortality and severe neurological outcome2,10,21,28,31). Aminmansour et al described an association between tSAH and an increased incidence of cerebral vasospasm, with higher probability and greater severity in patients with severe TBI2).…”

“…Therefore, tSAH in our study might have some additional effects on the incidence of vasospasm, relative to the effect of an isolated tSAH lesion, because our study was based on patients with traumatic SDH. In addition, a recent study from China showed that tSAH was an independent predictor of post-traumatic cerebral infarction21).…”