Young male presents with unhelmeted motorcycle accident and severe traumatic brain injury → intracranial pressure monitor → ultimately requires hemicraniectomy → post-trauma-day 5 MRI brain for prognostication
Cerebral infarction due to post-traumatic vasospasm
Cerebral infarction due to blunt cerebrovascular injury
Background
Post-traumatic vasospasm is a rare but serious cause of secondary injury in traumatic brain injury patients.
The onset of post-traumatic vasospasm is typically delayed and generally occurs 3-5 days following trauma.
If the vasospasm is severe enough to cause cerebral ischemia, then cerebral infarction may occur.
Because traumatic brain injury patients are frequently altered or unconscious due to their primary brain injury or sedating medications, vasospasm may go unrecognized.