Traumatic Occlusion of the Middle Cerebral Artery

Abstract

Traumatic occlusion of the middle cerebral artery (MCA) is very rare compared to occlusion of the internal carotid and basilar artery. Patients with longer latency have lower mortality. Herein, we report two cases of MCA occlusion who deteriorated under observation because of MCA territory infarction. CT angiography revealed occlusion of MCA in M1 segment. Both were subjected to decompressive craniotomy. First patient is ambulatory and has spastic gait. Second patient showed improvement in sensorium and still requires nursing care.

Keywords

posttraumatic occlusion - posttraumatic thrombosis - middle cerebral artery - decompressive craniectomy

• References

• 1 Takakura K, Saito I, Sasaki T. Special problems associated with subarachnoid hemorrhage. In: Youmans JR. Neurological Surgery. 3rd ed. Philadelhpia, PA: WB Saunders; 1990: 1864-1889
• 2 Brett EM. Vascular disorders of the nervous system in childhood. In: Brett EM. Pediatric Neurology. 3rd ed. New York, NY: Churchill Livingstone; 1997: 571-588
• 3 Bunai Y, Nagai A, Nakamura I, Akaza K, Ohya I. Posttraumatic thrombosis of middle cerebral artery. Am J Forensic Med Pathol 2001; 22: 299-302
• 4 Mobbs RJ, Chandran KN. Traumatic middle cerebral artery occlusion: case report and review of literature. Neurol India 2001; 49: 158-161
• 5 Lee SJ, Yee GT, Choi CY, Sohn MJ, Lee CH. Post-traumatic middle cerebral artery dissection-A case report. J Korean Neurotraumatol Soc 2009; 5: 22-24
• 6 Sedzimir CB. Head injury as a cause of internal carotid thrombosis. J Neurol Neurosurg Psychiatry 1955; 18: 293-296
• 7 Sakamom K, Kobayashi N. Traumatic middle cerebral artery occlusion. No Shinkei Gaishou 1971; 3: 381-394
• 8 Uchida K, Mine T, Takenaka N, Inoue H, Suga S, Shiga H. Post traumatic occlusion of intracranial vessels: a concept of €œdelayed traumatic cerebral infarction€. Neurotraumatology 1986; 9: 133-142
• 9 Han SR, Lee SJ, Yee GT, Choi CY, Sohn MJ, Lee CH. Post traumatic middle cerebral artery dissection. Case report. J Korean Neurotraumatol Soc 2009; 5: 22-24
• 10 Mohan IV. Current optimal assessment and management of carotid and vertebral spontaneous and traumatic dissection. Angiology 2013; 65: 274-283