[Brain infarct caused by trauma-induced intracranial pressure elevation. Clinical and computerized x-ray tomography...

Of 327 patients admitted to hospital with signs of trauma-induced raised intracranial pressure 41 had infarcts demonstrated by computed tomography (CT). The most common site was the area supplied by the posterior cerebral artery, usually ipsilaterally. Experience so far indicates that the infarcts are most commonly caused by transient, dynamically produced occlusion of the artery, more rarely by venous congestion, resulting from the raised intracranial pressure. Comparison of the morbidity and mortality rate of patients with and without infarction after trauma with signs of raised intracranial pressure indicates that an infarct clearly worsens prognosis. Infarcts can be easily distinguished from contusional foci by CT, although both have decreased density, because the former spread within the supply area of a vessel and, similarly to embolic or arteriosclerotic infarcts, produce contrast enhancement after administration of contrast media as an expression of a disturbed blood-brain barrier.