Hemispheric cerebral ischemia in traumatic brain injury: A report of four cases

Abstract

Vascular injury to brain as a secondary phenomenon is not uncommon in head injury. Abnormality in cerebral blood flow after head injury is well documented. There are plenty of reports of focal vascular insults in head injury; however hemispheric ischemia is not reported so far to the best of our knowledge. Four patients of hemispheric ischemia were treated in last 13 years time out of the total of 13167 patients admitted for head injury. Three patients were males of six months, 30 years and 34 years of age while the fourth patient was a 10-year-old-female. Road traffic accident, assault and fall from height were the mode of accident in these cases. Both the adults died while both the children survived with gross neurological deficits. All four patients had subarachnoid and subdural hematomas along with evidence of hyperextension injury suggested by abrasion on forehead. Severe form of vascular injury like hemispheric ischemia is rare. Subarachnoid and subdural hematoma and hyperextension injuries could be risk factors. Prognosis is poor. There is a need to identify a subgroup of patients at risk of such complications.

Keywords

cerebral infarction - secondary brain injury - traumatic hemispheric cerebral ischemia - vascular insult

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