Traumatic ischemic injury in a top of the basilar distribution: a case report

Autor: Mihir Gupta, Anudeep Yekula, David Barba, J. Scott Pannell, Jeffrey Tomlin
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: BMC Neurology, Vol 21, Iss 1, Pp 1-4 (2021)
Druh dokumentu: article
ISSN: 1471-2377
DOI: 10.1186/s12883-021-02207-7
Popis: Abstract Background Top of the basilar syndrome is a rare, heterogeneous disorder that has previously only been described in the setting of acute ischemic stroke in predominantly elderly patients. We present the first reported case of traumatic brain injury (TBI) causing ischemia in a top of the basilar distribution. Case presentation A 19-year-old woman suffered an acute subdural hematoma and sustained hypoxemia after being struck by a motor vehicle. Neurosurgical evacuation of the hematoma was undertaken. Magnetic resonance imaging revealed ischemic injury in the midbrain and diencephalic structures fitting a top of the basilar distribution. No associated vascular injury was identified. The patient was eventually discharged in a state of persistent unresponsive wakefulness. Conclusions Ischemia in a top of the basilar distribution may occur in the setting of TBI. A high degree of clinical suspicion is required to identify this disorder. Further study of the complex inflammatory microenvironment and associated tissue perfusion dynamics in TBI are needed in order to elucidate the mechanisms underlying ischemic injury patterns, develop management paradigms and predict prognosis.
Databáze: Directory of Open Access Journals
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