title: Cerebral Infarction after Traumatic Brain Injury: Incidence and Risk Factors.
abstract: OBJECTIVE
  Post-traumatic cerebral infarction (PTCI) is one of the most severe secondary insults after traumatic brain injury (TBI), and is known to be associated with poor outcome and high mortality rate. We assessed the practical incidence and risk factors for the development of PTCI.
  
  
  METHODS
  We conducted retrospective study on 986 consecutive patients with TBI from the period May 2005 to November 2012 at our institution. The definition of PTCI was made on non-enhanced CT scan based on a well-demarcated or fairly discernible region of low attenuation following specific vascular territory with normal initial CT. Clinical and radiological findings that related to patients' outcome were reviewed and statistically compared.
  
  
  RESULTS
  PTCI was observed in 21 (2.1%) patients. Of various parameters, age (p=0.037), initial Glasgow coma scale score (p<0.01), brain herniation (p=0.044), and decompressive craniectomy (p=0.012) were significantly higher in patients with PTCI than patients who do not have PTCI. Duration between accident and PTCI, patterns of TBI and vascular territory of PTCI were not specific. The mortality rates were significantly higher in patients with PTCI than without PTCI.
  
  
  CONCLUSIONS
  The development of PTCI is rare after TBI, but it usually results in serious outcome and high mortality. Early recognition for risks and aggressive managements is mandatory to prevent PTCI.
authors.affiliation: Department of Neurosurgery, Hanyang University Medical Center, Seoul, Korea.
authors.forename: Dong-Hyeon
authors.initials: DH
authors.lastname: Bae
authors.affiliation: Department of Neurosurgery, Hanyang University Medical Center, Seoul, Korea.
authors.forename: Kyu-Sun
authors.initials: KS
authors.lastname: Choi
authors.affiliation: Department of Neurosurgery, Hanyang University Medical Center, Seoul, Korea.
authors.forename: Hyeong-Joong
authors.initials: HJ
authors.lastname: Yi
authors.affiliation: Department of Neurosurgery, Hanyang University Medical Center, Seoul, Korea.
authors.forename: Hyoung-Joon
authors.initials: HJ
authors.lastname: Chun
authors.affiliation: Department of Neurosurgery, Hanyang University Medical Center, Seoul, Korea.
authors.forename: Yong
authors.initials: Y
authors.lastname: Ko
authors.affiliation: Department of Neurosurgery, Hanyang University Medical Center, Seoul, Korea.
authors.forename: Koang Hum
authors.initials: KH
authors.lastname: Bak
keywords: Brain injuries; Cerebral infarction; Craniocerebral trauma; Decompressive craniectomy; Glasgow coma scale; Hernia