Acute ischaemic stroke detected by continuous invasive brain tissue oxygen monitoring following traumatic brain injury

Introduction This report describes the first documented case of acute ischaemic stroke detected by continuous invasive brain tissue oxygen monitoring following traumatic brain injury. Case report A 27-year-old male sustained a severe traumatic brain injury following a high-speed motor vehicle accident with extensive injuries including dissection of both the right and left internal carotid arteries. In the setting of a randomised clinical trial, the patient had a continuous brain tissue oxygen monitoring device inserted into the right frontal lobe in addition to routine intracranial pressure monitoring. A subsequent ischaemic stroke was detected in real-time by continuous brain tissue oxygen monitoring. Discussion Ischaemic stroke may complicate traumatic brain injury, due to traumatic cerebrovascular injury or other mechanisms, and could be identified by marked reductions in brain tissue oxygen (PbtO 2 ) with implications for acute clinical management. Conclusion Critically low PbtO 2 may alert clinicians to the possibility of evolving ischaemic stroke in patients with traumatic brain injury.