Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Jul 25;5(4):313-322.
doi: 10.1016/j.jointm.2025.05.004. eCollection 2025 Oct.

Post-traumatic vasospasm: Epidemiology, specificities, risk factors, and therapeutics

Clara Perrault  1 , Audrey Melcus  1 , Etienne Lefevre  2   3 , Eimad Shotar  4 , David Ditchi  1 , Lamine Abdennour  1 , Vincent Degos  1   3 , Alice Jacquens  1   3
Affiliations
Review

Post-traumatic vasospasm: Epidemiology, specificities, risk factors, and therapeutics

Clara Perrault et al. J Intensive Med. .

Abstract

Post-traumatic vasospasm (PTV) of intracranial arteries is a serious complication of traumatic brain injury (TBI) that can lead to significant neurological deficits and ischemic brain lesions. Despite its clinical relevance, the pathogenesis of PTV is not fully understood, and effective management strategies remain a challenge. This review aims to synthesize the current knowledge on pathophysiology, risk factors, detection, prevention, and treatment of PTV. Early detection of PTV is made difficult by the complexity of TBI and its management. The gold standard for vasospasm detection remains digital subtraction angiography (DSA). However, noninvasive techniques such as transcranial Doppler (TCD) and S100 protein monitoring may assist in detecting PTV. Compared with vasospasm associated with aneurysmal subarachnoid hemorrhage (aSAH), PTV appears to occur earlier and to resolve more quickly. Several risk factors have been identified, including the severity of TBI, younger age, SAH, or the presence of other hematomas. Treatment options include nimodipine and endovascular therapies, such as angioplasty and milrinone, though these require careful management due to their invasive nature and potential hypotensive effect. PTV represents a critical complication of TBI, requiring early detection and timely intervention to prevent secondary brain injuries. Although current strategies, such as nimodipine and intra-arterial therapies, have shown promise, further research is needed to refine these approaches and improve outcomes. Enhanced understanding of PTV's pathophysiology, along with the development of more effective diagnostic and therapeutic tools, is essential for advancing patient care in TBI.

Keywords: Subarachnoid hemorrhage; Traumatic brain injury; Vasospams intracranial.

PubMed Disclaimer

Figures

Figure 1:
Figure 1
Secondary cerebral insult of systemic and central origin.
Figure 2:
Figure 2
Different patterns of cerebral vasospasms.
Figure 3:
Figure 3
Suggestion for management of PTV detection and treatment.
See this image and copyright information in PMC

References

    1. Poblete R.A., Zhong C., Patel A., Kuo G., Sun P.Y., Xiao J., et al. Post-traumatic cerebral infarction: a narrative review of pathophysiology, diagnosis, and treatment. Neurol Int. 2024;16(1):95–112. doi: 10.3390/neurolint16010006. - DOI - PMC - PubMed
    1. Bae D.H., Choi K.S., Yi H.J., Chun H.J., Ko Y., Bak K.H. Cerebral infarction after traumatic brain injury: incidence and risk factors. Korean J Neurotrauma. 2014;10(2):35–40. doi: 10.13004/kjnt.2014.10.2.35. - DOI - PMC - PubMed
    1. Vergouwen M.D., Vermeulen M., Roos Y.B. Effect of nimodipine on outcome in patients with traumatic subarachnoid haemorrhage: a systematic review. Lancet Neurol. 2006;5(12):1029–1032. doi: 10.1016/S1474-4422(06)70582-8. - DOI - PubMed
    1. Vergouwen M.D.I., Vermeulen M., van Gijn J., Rinkel G.J.E., Wijdicks E.F., Muizelaar J.P., et al. Definition of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage as an outcome event in clinical trials and observational studies. Stroke. 2010;41(10):2391–2395. doi: 10.1161/STROKEAHA.110.589275. - DOI - PubMed
    1. Dewan M.C., Rattani A., Gupta S., Baticulon R.E., Hung Y.C., Punchak M., et al. Estimating the global incidence of traumatic brain injury. J Neurosurg. 2018;130(4):1080–1097. doi: 10.3171/2017.10.JNS17352. - DOI - PubMed

LinkOut - more resources