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Critical care
Vasospasm in traumatic brain injury
  1. Inês Miranda Carqueja1,
  2. Adriana América Silva2,
  3. Luís Albuquerque3 and
  4. Elisabete Monteiro4
  1. 1Intensive Care Medicine, Hospital Pedro Hispano, Matosinhos, Portugal
  2. 2Intensive Care Medicine, Centro Hospitalar Tâmega e Sousa, EPE, Penafiel, Portugal
  3. 3Neuroradiology, Centro Hospitalar Universitário de São João, Porto, Portugal
  4. 4Neurocritical Care, Intensive Care Medicine, Centro Hospitalar Universitário de São João, Porto, Portugal
  1. Correspondence to Dr Inês Miranda Carqueja; inescarqueja{at}gmail.com

Abstract

Traumatic brain injury (TBI) is a leading cause of morbidity and mortality in young individuals. Management of TBI is complex and aims to prevent secondary injury and optimise conditions for neurological recovery. Vasospasm is a possible complication of TBI, and its significance is unknown. Its incidence is underestimated and there are currently no preventive or therapeutic approaches with proven efficacy. The occurrence of vasospasm contributes to secondary brain injury and worsens prognosis. The diagnosis of vasospasm in TBI is challenging due to the difficulty in perceiving neurological deterioration in these patients. We present a case of a young patient admitted to the neurocritical care unit following TBI. He presented a partial neurological recovery, followed by clinical deterioration and persistent coma. The diagnosis of extensive ischaemic lesions due to severe vasospasm was established. Suspicion of vasospasm and timely screening, particularly in high-risk patients, may improve survival and outcomes in TBI.

  • Brain Injuries, Traumatic
  • Adult intensive care
  • Neuro ITU
  • Neurosurgery

https://doi.org/10.1136/bcr-2024-262308

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    Footnotes

    • Contributors All authors (IMC, AAS, EM and LA) were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content. All authors gave final approval of the manuscript. Guarantor: IMC.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.