Unilateral borderzone infarction in a young polytrauma patient

Area of Science:

• Neurology
• Trauma Surgery
• Radiology

Background:

• Post-traumatic cerebral infarction is a recognized complication of head trauma.
• Borderzone infarction (BZI) is infrequently reported in young adults following multiple traumas.
• Existing literature on BZI in this demographic is notably scarce.

Purpose of the Study:

• To report an unusual case of unilateral BZI in a young adult with multiple traumas.
• To underscore the importance of considering BZI in trauma patients presenting with neurological deficits disproportionate to initial head injury severity.
• To highlight the diagnostic utility of serial neuroimaging and vascular assessment.

Main Methods:

• Case presentation of a 21-year-old male with multiple traumas including mild head injury.
• Initial head CT revealed mild brain edema.
• Repeated brain CT identified unilateral BZI due to delayed neurological deficit.
• CT angiography disclosed a narrowed right internal carotid artery.

Main Results:

• The patient developed a delayed neurological deficit inconsistent with the initial head injury.
• A unilateral borderzone infarction was diagnosed on a follow-up CT scan.
• CT angiography revealed significant narrowing of the right internal carotid artery.

Conclusions:

• Unilateral BZI is an uncommon but possible complication in young trauma patients.
• Emergency physicians should maintain a high index of suspicion for BZI in trauma cases with unexpected neurological deterioration.
• Serial neurological examinations and timely neuroimaging are crucial for early BZI detection and management.