Prolonged Post-Traumatic Vasospasm Resulting in Delayed Cerebral Ischemia After Mild Traumatic Brain Injury

Excerpt

Post-traumatic vasospasm (PTV) is an important cause of secondary brain injury in patients with severe traumatic brain injury (TBI) and independently predicts poor outcomes [1, 2]. The incidence of PTV has been varyingly reported from 35.6 to 61% [3‐8]. Important risk factors for PTV include severity of TBI determined by the Glasgow coma score (GCS) and radiographic criteria, young age, fever on admission and volume of cisternal blood [3, 9]. PTV has been associated with traumatic subarachnoid hemorrhage (tSAH), a marker of severity of TBI [5, 10]. Increased incidence of PTV has also been linked with worse Rotterdam Scores [9]. PTV usually begins around day 2–3 and lasts from 5 to 10 days [3, 5]. Moreover, less than 20% of patients develop clinical sequelae from PTV, mostly seen in severe TBI [3, 5, 10]. …