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Correlation between angiographic findings and the ischaemia of head injury
Insights
Carotid angiograms revealed that arterial spasm and intracranial hematoma significantly correlate with ipsilateral cortical ischemic brain damage after head injury. Cerebral circulation slowing showed limited association with ischemic damage.
Area of Science:
- Neurology
- Radiology
- Pathology
Background:
- Non-missile head injuries can lead to complex cerebrovascular complications.
- Assessing cerebral circulation and structural changes is crucial for understanding brain damage.
- Carotid angiography is a key diagnostic tool in evaluating head trauma sequelae.
Purpose of the Study:
- To investigate the relationship between angiographic findings and ischemic brain damage in non-missile head injury patients.
- To determine the specific roles of arterial spasm, cerebral circulation slowing, and intracranial hematoma in causing cortical ischemia.
Main Methods:
- Retrospective review of carotid angiograms from 96 deceased patients with non-missile head injury.
- Correlation analysis between angiographic findings (spasm, circulation slowing, hematoma) and observed ischemic brain damage in 140 cerebral hemispheres.
- Bilateral angiography performed in 44 cases for comprehensive assessment.
Main Results:
- A significant association was found between arterial spasm, intracranial hematoma, or their combination, and ipsilateral cortical ischemic damage.
- Severe arterial spasm showed some correlation with slowed cerebral circulation in ischemic territories.
- Slowing of cerebral circulation, alone or combined with spasm or hematoma, had limited association with ischemic brain damage.
Conclusions:
- Arterial spasm and intracranial hematoma are significant predictors of ipsilateral ischemic brain damage following non-missile head injury.
- Cerebral circulation slowing appears to be a less consistent indicator of ischemic brain damage in this context.
- Angiographic assessment is vital for identifying risk factors for ischemic brain damage after head trauma.
Abstract:
The carotid angiograms of 96 patients who had died from non-missile head injury were reviewed and assessed for evidence of arterial spasm, slowing of the cerebral circulation, and the presence of intracranial haemotoma. As bilateral angiography had been done in 44 cases the results are based on a correlation between the angiographic appearances and the presence or absence of ischaemic brain damage in the cortex of 140 cerebral hemispheres. There was a significant relationship between spasm alone, the presence of intracranial haematoma alone, or their combination, and ischaemic damage in the ipsilateral cortex. Apart from an association between the more severe grades of spasm and slowing of circulation in the group with ischaemia within arterial territories, there was none between slowing of the circulation or the combination of slowing with either spasm or haematoma and ischaemic brain damage.