Patients with Blunt Traumatic Brain Injury: A Role for Computed Tomography Angiography of the Head to Evaluate Nontraumatic Causes? World Neurosurg 2017 May;101:506-508
Date
02/19/2017Pubmed ID
28213195DOI
10.1016/j.wneu.2017.02.042Scopus ID
2-s2.0-85016413814 (requires institutional sign-in at Scopus site) 4 CitationsAbstract
BACKGROUND: In the setting of trauma, the cause of intracranial hemorrhage (ICH) is frequently attributed to the physical, traumatic event. Caution should still be directed toward nontraumatic (or spontaneous) causes responsible for the trauma, such as hypertension, cerebral amyloid angiopathy, aneurysms, vascular malformation, and hemorrhagic infarcts. The role for immediate computed tomography angiography remains controversial to evaluate for nontraumatic causes.
METHODS: A systematic review of the available literature in the Medline PubMed database.
RESULTS: In the available literature, only 12 patients with traumatic brain injury underwent computed tomography angiography of the head that either showed a vascular malformation and/or altered clinical management because of concerns of a vascular malformation. The ICH in 11 patients was attributed to rupture of a cerebral aneurysm; the other patient received a diagnostic angiogram that was negative.
CONCLUSIONS: ICH in patients with traumatic brain injury seems to be vastly associated with the traumatic event. Only rare cases have been attributed to aneurysmal rupture. None has been associated with arteriovenous malformation. Nevertheless, clinical vigilance remains reasonable, especially in younger patients and those with hemorrhage within the subarachnoid cisterns or sylvian fissure.
Author List
Nguyen HS, Doan N, Gelsomino M, Shabani SAuthor
Saman Shabani MD Assistant Professor in the Neurosurgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Brain Injuries, TraumaticComputed Tomography Angiography
Glasgow Coma Scale
Head
Humans
