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Posttraumatic hemicerebral infarction in a four-year-old girl
Gholamreza Faridaalaee1, Alireza Taghian2, Tannaz Sattarzadeh Ghadim1
1Department of Emergency Medicine, Urmia University of Medical Sciences, Urmia, IR Iran.
Insights
Brain infarction following trauma is rare. This case highlights a child experiencing brain infarction and subdural hematoma after a car accident, emphasizing the critical need for prompt diagnosis and management of traumatic brain injuries.
Area of Science:
- Neurology
- Pediatric Traumatology
Background:
- Traumatic brain injury can lead to cerebrovascular complications.
- Brain infarction is an uncommon consequence of head trauma.
Observation:
- A 4-year-old girl sustained a car accident injury with initial presentation of subdural hematoma.
- Neurological status deteriorated, evidenced by decreased Glasgow Coma Scale (GCS) score.
- Brain imaging confirmed the development of brain infarction.
Findings:
- The case illustrates a rare instance of post-traumatic brain infarction in a pediatric patient.
- Synchronous occurrence of subdural hematoma and brain infarction was observed.
- The patient's condition progressed to a fatal outcome.
Implications:
- This case underscores the potential for severe neurological complications after seemingly minor head trauma.
- Highlights the importance of vigilant monitoring for delayed complications like brain infarction in pediatric trauma.
- Emphasizes the need for advanced neuroimaging and timely intervention in managing traumatic brain injuries.
Introduction:
Brain infarction after trauma is uncommon. Injury of the carotid and vertebrobasilar arteries can cause brain infarction due to occlusion of brain blood flow.
Case Presentation:
Emergency medical service (EMS) brought a 4-year-old girl involved in a car accident to the emergency room. She had had seizure controlled by diazepam. She was unconscious and her Glasgow coma scale (GCS) score was eight. Early vital signs were stable. Her first brain CT scan showed a subdural hematoma (SDH). One day after admission to ICU, her GCS decreased to five; hence, a control brain CT was performed. The brain CT scan showed a brain infarction. Six days after admission, her status worsened and her GCS dropped to three and her pupils became dilated bilaterally and unresponsive to light; she was pronounced dead.
Discussion:
We present an uncommon case of posttraumatic brain infarction and synchronous SDH.
