Successful recovery of a young man with traumatic brainstem ischemia in a motor vehicle accident

Abstract

Introduction: The most common etiological factors of brainstem stroke and ischemia are atherosclerosis, thromboembolism, tumours, arterial dissection, and trauma. Infarction of the medulla oblongata in 73% of cases occurs as a result of stenosis of the vertebral arteries, 26% due to arterial dissection, while the topic of traumatic brainstem ischemia is still under-researched and under-represented. Case report: We present a case of a 26-year-old male patient who was admitted to the Emergency Department due to multiple injuries of the head, chest, and upper, and lower extremities sustained as a motorcyclist in a traffic accident. A cranial CT scan revealed the presence of a minor subdural hematoma, traumatic brainstem ischemia, and a ruptured peduncular artery. From a neurosurgical perspective, surgical treatment was not indicated, thus a conservative therapeutic approach was adopted. After five days after admission, initial radiographic signs of ischemia regression were recorded, followed by complete absence. Conclusion: Timely patient transportation from the accident site to the Emergency Center, followed by an appropriate multidisciplinary treatment approach and intensive neuroprotective and neuroregenerative therapy, along with organism reperfusion, played a pivotal role in the neurological, and subsequently, overall patient recovery in this case presentation.

Keywords

• brainstem ischemia
• ICU
• neurosurgery
• radiology
• neurology