Post-traumatic Early Cerebral Infarct: MRI-based Analysis of Incidence and Radiological Distribution
Dr. Shashank Sah,
Assistant Professor, Department of Neurosurgery, Shri Ram Murti Smarak-Institute of Medical Sciences, Nainital Highway, Bareilly-243202, Uttar Pradesh, India.
Introduction: Traumatic Brain Injury (TBI) is an alteration in brain function brought on by external trauma. Computed Tomography (CT) scanning is the mainstay diagnostic modality for evaluating the primary injury, as well as secondary events such as oedema, mass effect, herniation, infarction, etc., which are often catastrophic and responsible for morbidity and mortality. Early cerebral infarction, unless large and in a defined vascular territory, is quite likely to be missed on CT scans and can even be confused with cerebral oedema. In the diagnosis of early infarctions, especially the lacunar types, the detection rate of lesions with Magnetic Resonance Imaging (MRI) is significantly higher than that of CT.
Aim: To observe the incidence, distribution, and pattern of Post-traumatic Cerebral Infarction (PTCI) and its association with neurological deterioration.
Materials and Methods: In this cross-sectional study, 55 patients with head injuries admitted to the Department of Neurosurgery were evaluated between 72 to 96 hours post-trauma using Magnetic Resonance Imaging (MRI) of the brain (1.5 Tesla Siemens). Observations were made regarding the presence and pattern of any infarction, as well as its impact on the patients.
Results: Post-traumatic early cerebral infarction was detected in 19 out of 55 (34.5%) patients. Infarct distribution was observed in nearly all defined vascular territories, with the most common occurrence in the Middle Cerebral Artery (MCA) territory. Neurological deficit was observed in four out of 19 infarcted cases during the hospitalisation period.
Conclusion: Post-traumatic early cerebral infarction is common in head injuries and can lead to neurological deterioration. MRI is sensitive in detecting infarcts, especially the lacunar ones.