Posterior communicating artery injury and symptomatic vasospasm after high-energy blunt head injury: illustrative case

Nidal B Omar; Gustavo Chagoya; Dario Marotta; Galal Elsayed; Mark R Harrigan

doi:10.3171/CASE2053

Posterior communicating artery injury and symptomatic vasospasm after high-energy blunt head injury: illustrative case

J Neurosurg Case Lessons. 2021 Feb 22;1(8):CASE2053. doi: 10.3171/CASE2053.

Authors

Nidal B Omar¹, Gustavo Chagoya¹, Dario Marotta², Galal Elsayed¹, Mark R Harrigan¹

Affiliations

¹ Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama; and.
² Alabama College of Osteopathic Medicine, Dothan, Alabama.

Abstract

Background: Most of the published literature pertaining to blunt traumatic cerebrovascular injury (BCVI) is focused on extracranial arterial injury. Studies of intracranial arterial injury are relatively uncommon.

Observations: The clinical course of a patient who sustained an injury to the right posterior communicating artery followed by infarction due to vasospasm after severe traumatic brain injury is presented, along with a focused literature review.

Lessons: Intracranial BCVI is uncommon, and this report may serve to raise awareness of BCVI management and the importance of recognizing symptomatic vasospasm due to BCVI.

Keywords: BCVI = blunt traumatic cerebrovascular injury; CT = computed tomography; CTA = computed tomography angiogram; DSA = digital subtraction angiography; ICA = internal carotid artery; ICP = intracranial pressure; MCA = middle cerebral artery; NICU = neurological intensive care unit; PComm = posterior communicating artery; SAH = subarachnoid hemorrhage; aSAH = aneurysmal subarachnoid hemorrhage; blunt traumatic cerebrovascular injury; cerebral artery avulsion; severe traumatic brain injury; symptomatic vasospasm; tSAH = traumatic subarachnoid hemorrhage; traumatic subarachnoid hemorrhage.

Publication types

Case Reports