Vasospasm in traumatic brain injury

Traumatic brain injury (TBI) is a leading cause of morbidity and mortality in young individuals. Management of TBI is complex and aims to prevent secondary injury and optimise conditions for neurological recovery. Vasospasm is a possible complication of TBI, and its significance is unknown. Its incidence is underestimated and there are currently no preventive or therapeutic approaches with proven efficacy. The occurrence of vasospasm contributes to secondary brain injury and worsens prognosis. The diagnosis of vasospasm in TBI is challenging due to the difficulty in perceiving neurological deterioration in these patients. We present a case of a young patient admitted to the neurocritical care unit following TBI. He presented a partial neurological recovery, followed by clinical deterioration and persistent coma. The diagnosis of extensive ischaemic lesions due to severe vasospasm was established. Suspicion of vasospasm and timely screening, particularly in high-risk patients, may improve survival and outcomes in TBI.