Unilateral borderzone infarction in a young polytrauma patient

Although post-traumatic cerebral infarction is a known complication of craniocerebral trauma, borderzone infarction (BZI) after multiple traumas in young adults are uncommon and published data on this are extremely scant. We present an unusual occurrence of unilateral borderzone infarction in a 21-year-old male who sustained multiple traumas in a traffic accident, which included mild head injury, blunt cardiac injury, right traumatic hemopneumothorax, and three long bone open fractures. Initial head scan revealed mild brain edema, and the BZI was uncovered by a repeated brain CT scan since the patient had a delayed neurological deficit which was incompatible for the injury severity of the head. Comprehensive work-up was performed and a narrowed right internal carotid artery was disclosed by CT angiography. Although unilateral BZI is extremely rare in young patients, emergency physicians should still keep in mind to warrant serial examinations for BZI and early recognition to provide appropriate treatment.