Cerebrovascular Injuries in Traumatic Brain Injury

Authors

Alvin S. Das, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.
Juan C. Vicenty-Padilla, Department of Neurosurgery, San Jorge Children & Women's Hospital, Santurce, PR, United States.
Melissa M. Chua, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
Yasser Jeelani, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
Samuel B. Snider, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
Robert W. Regenhardt, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
Fawaz Al-Mufti, Department of Neurology, Neurosurgery, and Radiology Neuroendovascular Surgery, Westchester Medical Center, New York Medical College, Valhalla, NY, United States.Follow
Rose Du, Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
Saef Izzy, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States. Electronic address: sizzy@bwh.harvard.edu.

Author Type(s)

Faculty

DOI

10.1016/j.clineuro.2022.107479

Journal Title

Clinical Neurology and Neurosurgery

First Page

107479

Document Type

Article

Publication Date

12-1-2022

Department

Neurology

Abstract

Traumatic brain injury is a complex and highly heterogeneous disease due to the host of concomitant injuries that may accompany the initial insult. Due to the dynamic interplay between the injuries that may arise, the management of these injuries is challenging. In a small subset of patients with traumatic brain injury, cerebral vascular injury may occur, which presents its own diagnostic and therapeutic challenges. These vascular injuries often present in a delayed fashion, thereby going unnoticed by clinicians. Early recognition and treatment of these injuries is crucial, given their high morbidity and mortality. Through a critical review of the literature, we present the spectrum of cerebrovascular injuries that may occur with traumatic brain injury and discuss classification systems that are used to stratify cerebrovascular injury. We then focus on the diagnosis of cerebral vascular injury using different neuroimaging modalities. Lastly, we explore the treatment of these injuries ranging from antiplatelet therapies to endovascular and open vascular procedures. By highlighting the pitfalls and challenges of this complex disease, we hope to provide clinicians with the framework to recognize and treat vascular injuries that are seen in patients with traumatic brain injury.

Recommended Citation

Das, A. S., Vicenty-Padilla, J. C., Chua, M. M., Jeelani, Y., Snider, S. B., Regenhardt, R. W., Al-Mufti, F., Du, R., & Izzy, S. (2022). Cerebrovascular Injuries in Traumatic Brain Injury. Clinical Neurology and Neurosurgery, 223, 107479. https://doi.org/10.1016/j.clineuro.2022.107479