Cerebral Vasospasm in Traumatic Brain Injury: A Case Study

CME Educational Objectives 1. Review the expanded differential diagnosis of mental status changes in the patient with mild to severe traumatic brain injury. 2. Discuss the workup and monitoring for suspected cerebral vasospasm in patients with a history of traumatic subarachnoid hemorrhage. 3. Review potential therapeutic options for mental status changes attributed to cerebral vasospasm. An unemployed young man with a history of poly-substance abuse suffered a closed head injury as the result of a motor vehicle crash. At the scene, the patient had a prolonged period of unconsciousness and was intubated. Computed tomography (CT) of the brain upon arrival to the trauma center reveals a mild bilateral subarachnoid hemorrhage (SAH) in a nonspecific pattern. The imaging is thought to be consistent with trauma and is without a space occupying lesion.