Two Cases of Posttraumatic Middle Cerebral Artery Occlusion

ABSTRACT

While posttraumatic occlusion of the extracranial carotid and vertebral arteries is well known, reports of occlusion of intracranial vessels following closed head injury are rare. Since Deveer and Browder reported the first case in 1942, only 22 cases of posttraumatic middle cerebral artery occlusion have been reported until now. We experienced 2 cases of posttraumatic middle cerebral artery occlusion recently. One patient was 27 years old male who developed right hemiplegia after relatively minor head injury. Reported angiograms taken on the 13th day after trauma revealed sparse middle cerebral artery branches with retrograde filling through left anterior cerebral artery in middle cerebral artery territory. He showed relatively satisfactory recovery by conservative treatment with steroid and cerebral vasodilator. The other patient became semicomatous with left hemiplegia after fall down accident from running train. Left carotid angiograms showed complete obstruction of left middle cerebral artery in its initial portion with corresponding avascular area. This patient died one week after the angiography in spite of all possible conservative care.