Acute arterial infarcts in patients with severe head injuries

Aims and Objectives To study the incidence, demographic profile, and outcome of patients with severe closed head injuries who develop acute arterial infarcts. Materials and Methods Patients with severe head injury (Glasgow coma score (GCS) ≤8) presenting within 8 h of injury in the Depar...

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Main Authors: Deepak Agrawal, Anil Garg
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2012-07-01
Series:Indian Journal of Neurosurgery
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.4103/2277-9167.102276
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author Deepak Agrawal
Anil Garg
author_facet Deepak Agrawal
Anil Garg
author_sort Deepak Agrawal
collection DOAJ
description Aims and Objectives To study the incidence, demographic profile, and outcome of patients with severe closed head injuries who develop acute arterial infarcts. Materials and Methods Patients with severe head injury (Glasgow coma score (GCS) ≤8) presenting within 8 h of injury in the Department of Neurosurgery over a period of 5 months were enrolled in the study. Patients with penetrating head injury, infarct due to herniation and iatrogenic arterial injuries were excluded from the study. Only arterial infarcts developing within 8 h of injury were included in the study. A computed tomography (CT) head was done on all patients within 8 h of injury and repeated if necessary. Arterial infarct was defined as well-demarcated wedge-shaped hypodensity corresponding to an arterial territory on plain CT of the head. Outcome was assessed using Glasgow outcome score (GOS) at 1 month post-injury or at death (whichever came earlier). Results Forty-four patients of severe head injury were included in the study during the above period. Of these, four patients (9.1%) had arterial infarcts on the initial CT scan. The male:female ratio was 1:3. The mean age was 54 years (range 3–85 years). Two patients had infarcts in the middle cerebral artery distribution and two in the superior cerebellar artery distribution. Poor outcome (GOS 1–3) was seen in 100% of the patients with arterial infarct compared to 52.5% (n=21) in patients with severe head injury without arterial infarct. Conclusions A significant percentage of patients with severe head injury have arterial infarcts on admission, which may imply arterial injury. Our study shows that these patients have a poorer prognosis vis-à-vis patient without these findings
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spelling doaj-art-0de5cda3ad3448df826f1cf31bba5f792025-08-20T03:55:33ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Neurosurgery2277-954X2277-91672012-07-01010212612910.4103/2277-9167.102276Acute arterial infarcts in patients with severe head injuriesDeepak AgrawalAnil GargAims and Objectives To study the incidence, demographic profile, and outcome of patients with severe closed head injuries who develop acute arterial infarcts. Materials and Methods Patients with severe head injury (Glasgow coma score (GCS) ≤8) presenting within 8 h of injury in the Department of Neurosurgery over a period of 5 months were enrolled in the study. Patients with penetrating head injury, infarct due to herniation and iatrogenic arterial injuries were excluded from the study. Only arterial infarcts developing within 8 h of injury were included in the study. A computed tomography (CT) head was done on all patients within 8 h of injury and repeated if necessary. Arterial infarct was defined as well-demarcated wedge-shaped hypodensity corresponding to an arterial territory on plain CT of the head. Outcome was assessed using Glasgow outcome score (GOS) at 1 month post-injury or at death (whichever came earlier). Results Forty-four patients of severe head injury were included in the study during the above period. Of these, four patients (9.1%) had arterial infarcts on the initial CT scan. The male:female ratio was 1:3. The mean age was 54 years (range 3–85 years). Two patients had infarcts in the middle cerebral artery distribution and two in the superior cerebellar artery distribution. Poor outcome (GOS 1–3) was seen in 100% of the patients with arterial infarct compared to 52.5% (n=21) in patients with severe head injury without arterial infarct. Conclusions A significant percentage of patients with severe head injury have arterial infarcts on admission, which may imply arterial injury. Our study shows that these patients have a poorer prognosis vis-à-vis patient without these findingshttp://www.thieme-connect.de/DOI/DOI?10.4103/2277-9167.102276arterial dissectionarterial infarctcomputerized tomographyepidemiologyhead injurytrauma
spellingShingle Deepak Agrawal
Anil Garg
Acute arterial infarcts in patients with severe head injuries
Indian Journal of Neurosurgery
arterial dissection
arterial infarct
computerized tomography
epidemiology
head injury
trauma
title Acute arterial infarcts in patients with severe head injuries
title_full Acute arterial infarcts in patients with severe head injuries
title_fullStr Acute arterial infarcts in patients with severe head injuries
title_full_unstemmed Acute arterial infarcts in patients with severe head injuries
title_short Acute arterial infarcts in patients with severe head injuries
title_sort acute arterial infarcts in patients with severe head injuries
topic arterial dissection
arterial infarct
computerized tomography
epidemiology
head injury
trauma
url http://www.thieme-connect.de/DOI/DOI?10.4103/2277-9167.102276
work_keys_str_mv AT deepakagrawal acutearterialinfarctsinpatientswithsevereheadinjuries
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