Posttraumatic cerebral arterial spasm.
Posttraumatic cerebral arterial spasm (vasospasm) has been demonstrated in the past by angiography, and recently by transcranial Doppler ultrasonography. Posttraumatic vasospasm is a delayed complication that involves the large basal intracranial arteries (e.g., internal carotid, middle cerebral, basilar) and occurs in 25-40% of head trauma patient. The time course of posttraumatic vasospasm resembles that of vasospasm associated with aneurysmal subarachnoid hemorrhage with onset occurring 2 or more days after injury. A study of the relationship of admission CT scan findings to the incidence of vasospasm suggests that intradural bleeding, which extends into the CSF (subarachnoid, intraventricular, and subdural hemorrhage), plays a role in the pathogenesis of posttraumatic arterial spasm. The preliminary results of a large prospective study of head trauma patients suggest that vasospasm may be an important determinant of outcome from severe head injury.
Martin
N A
NA
Cerebral Blood Flow Laboratory, UCLA Schools of Medicine and Public Health 90024, USA.
Doberstein
C
C
Alexander
M
M
Khanna
R
R
Benalcazar
H
H
Alsina
G
G
Zane
C
C
McBride
D
D
Kelly
D
D
Hovda
D
D
D001930:Brain Injuries / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D002546:Ischemic Attack, Transient / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D011446:Prospective Studies; D012306:Risk; D013035:Spasm / Q000209:etiology / Q000503:physiopathology