Risk factors for post traumatic cerebral infarction in patients with moderate or severe traumatic brain injury

Abstract:

Objective：To evaluate the risk factors for post traumatic cerebral infarction（PTCI） in patients with moderate or severe traumatic brain injury（TBI）. Methods：A retrospective review of 327 moderate or severe TBI patients admitted to our department between January 2010 and December 2011 was performed. Patients who had a history of cerebral infarction，severe heart disease，poorly controlled hypertension，hyperlipidemia and diabetes，and Glasgow coma scores（GCS） of more than 12 were excluded to avoid interfering factors. Patients who died during the first 3 d after the admission were also excluded. All cases were analyzed in aspects of gender，age，GCS，basal skull base fracture，traumatic subarachnoid hemorrhage（tSAH），cerebral hernia，low blood pressure or shock，decompression craniotomy. Statistical analysis was performed using chi-square and student’s t test. Multivariate analysis was per－formed using logistic regression to identify independent risk factors for the development of PTCI. Results：There were 37 cases（11.31%） suffering from PTCI. Attack rate of PTCI for patients with GCS 3-8 was 16.11%（34/211） while for patients with GCS 9-12 was 2.59%（3/116）. High attack rate of PTCI after moderate or severe TBI was also related with basal skull base fracture（19.74%，15/76），tSAH（14.89%，32/215），cerebral hernia（17.95%，14/78），low blood pressure or shock（20.00%，15/75） and decompression craniotomy（14.61%，26/178），with significant correlations（P=0.001，0.031，0.029，0.039，0.001，0.043）.While the patients’ age and gender were not associated with the development of PTCI（P=0.353，0.882）. Conclusions：Low GCS，basal skull base fracture，tSAH，cerebral hernia，low blood pressure or shock，and decompression craniotomy are risk factors for PTCI in patients with moderate or severe TBI. No association is observed between PTCI and gender or increasing age.