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[Traumatic middle cerebral artery occlusion]

M Miyata1, S Yamasaki, A Hirayama

  • 1Department of Neurosurgery, Takatsuki General Hospital.

No Shinkei Geka. Neurological Surgery
|March 1, 1994
PubMed
Summary

Head trauma in a teen rugby player caused temporary neurological deficits. Angiography revealed middle cerebral artery stenosis and occlusion, likely due to intracranial carotid artery injury, which later resolved.

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Area of Science:

  • Neurology
  • Vascular Neurology
  • Traumatic Brain Injury

Background:

  • Sports-related head trauma can lead to diverse neurological complications.
  • Cerebral artery dissection and vasospasm are potential, though less common, sequelae.

Observation:

  • A 16-year-old male experienced acute motor aphasia and right hemiplegia post-rugby head trauma.
  • Neurological deficits resolved rapidly within 2 hours.
  • Initial CT was normal; subsequent imaging revealed left basal ganglia abnormalities, left middle cerebral artery (MCA) stenosis, and anterior temporal artery occlusion.

Findings:

  • Cerebral angiography demonstrated severe left MCA M1 stenosis, distal vasospasm, and anterior temporal artery occlusion.
  • Follow-up angiography showed MCA stenosis resolution, normalized vasospasm, and recanalization of the anterior temporal artery.
  • The likely pathogenesis involved intimal injury to the intracranial internal carotid artery, leading to spasm or thrombus formation and subsequent embolization.

Implications:

  • This case highlights the possibility of traumatic intracranial artery injury presenting with transient neurological deficits.
  • It underscores the importance of advanced vascular imaging in evaluating seemingly resolved post-traumatic neurological symptoms.
  • The findings suggest that prompt recognition and management of traumatic cerebrovascular injury can lead to favorable outcomes.

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