Occipital Cerebral Infarction as a Complication of Traumatic Brain Injury: A Case Report.

Abstract

Abstract

Background: Post-traumatic cerebral infarction (PTCI) is a severe consequence of secondary brain injury which is associated with poor functional recovery and high mortality. Despite advances in neurocritical care and decompressive craniectomy, outcomes remain poor.

Case Presentation: We report a 22-year-old female who sustained a severe TBI following a road traffic accident. On admission, her Glasgow Coma Scale (GCS) was 8/15 with sluggishly reactive pupils. A non-contrast CT scan revealed a left parietal-temporal acute subdural hematoma with 13 mm midline shift and multiple contusions. Emergency decompressive craniectomy was performed. Despite surgical decompression and neurocritical management, her neurological status deteriorated, and a follow-up CT scan on postoperative day three revealed a left occipital infarction in the PCA territory consistent with transtentorial herniation. The patient succumbed on postoperative day eight.

Conclusion: PTCI remains a catastrophic but often under-recognized complication of TBI. Early detection through neurological monitoring and timely neuroimaging, coupled with intracranial pressure and cerebral perfusion control, may mitigate risk. However, prognosis remains guarded, emphasizing the need for improved neuroprotective and vascular-targeted interventions.