الفهرس 
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Abstract
BACKGROUND
Posttraumatic cerebral infarction (PTCI) is a known complication of craniocerebral trauma. A variety of mechanisms may account for this complication including cerebral vasospasm, direct vascular compression by mass effect, vascular injury including dissecting aneurysm and thrombus formation, embolization, and systemic hypoperfusion. It is considered the most common cause of secondary brain injury in the setting of severe head injury; the secondary brain injury may be more devastating than those sustained from primary injury.
Ischemic damage can be precipitated by intracranial hypertension, systemic arterial hypotension, or changes in blood viscosity or coagulation cascade following head injury because normal physiological adaptive mechanisms (the vasomotor response to changes in perfusion pressure) may be impaired or abolished.
OBJECTIVE
The aim of this study is to determine the prevalence, the origin, the radiological characteristics of posttraumatic cerebral infarction (PTCI) as regarding the etiology and site of infarction, and to provide neuro-imaging indicator of a poor clinical outcome.
METHODS
The study will be carried out on 30 patients of both sexes with moderate and severe head injuries who developed post-traumatic cerebral infarction will be admitted to Critical care and Emergency department of Alexandria University hospital, presenting with head injury. All patients were adopted for complete history tacking, clinical assessment, routine investigations, Brain computed scan done on admission and within 10 days.
RESULTS
The present study revealed that the delay time of patients with head injuries, Mean arterial blood pressure on admission, the partial pressure of oxygen on admission were significantly related to both the outcome of head injury patients and the size of post-traumatic cerebral infarction. The present study revealed that the mean value of mean arterial blood pressure in the first, second and third day were not significantly related to the outcome of the head injured patients and the size of post-traumatic cerebral infarction. On the other hand the total duration of periods of hypotension were significantly related to the outcome of the head injured patients and the size of post-traumatic cerebral infarction. The present study revealed that the mean value of pulse oxymetry readings in the first, second day were significantly related to the outcome of the head injured patients and the size of post-traumatic cerebral infarction (except the first day was not related to the size of infarction). On the other hand the total number of periods of hypoxia were not significantly related to the outcome of the head injured patients and the size of post-traumatic cerebral infarction. The present study revealed that the mean values of CVP and PC02 in first day of the patients with head injuries were significantly related to the outcome of head injury patients and the size of post-traumatic cerebral infarction. The present study also revealed that the WBC and hemoglobin concentration on admission of the patients with head injuries were significantly related to the outcome of head injury patients and the size of post-traumatic cerebral infarction. The present study revealed that the initial CT brain on admission of the patients with head injuries were significantly related to the outcome of head injury patients, the size and the number of post-traumatic cerebral infarction, but were not significantly related to the site and the occurrence of perifocal oedema and hemorrhagic transformation of post-traumatic cerebral infarction. The present study revealed that the size and the number of post-traumatic cerebral infarction were significantly related to the outcome of the head injured patients. A multiple logistic regression analysis of all variables recorded in the studied patients with dependant variable Glasgow Outcome Score as survivor and non survivor revealed that mean arterial blood pressure on admission, total duration of periods of hypotension, mean value of pulse oxymetry reading in 2nd day, the partial pressure of carbon dioxide in the 1st day, initial brain lesion on admission CT, the number and size of posttraumatic cerebral infarction and the presence of perifocal oedema in post-traumatic cerebral infarction were considered independent risk factors for mortality.