Blunt cerebrovascular injuries: redefining screening criteria in the era of noninvasive diagnosis

The Journal of Trauma and Acute Care Surgery
Clay Cothren BurlewDenis D Bensard

Abstract

Screening for blunt cerebrovascular injuries (BCVIs) and early treatment has virtually eliminated injury-related strokes. Screening protocols developed in the 1990s captured ∼80% of ultimately identified BCVI. With the availability of noninvasive diagnosis with computed tomographic angiography, broader indications for screening seem warranted. The purpose of this study was to identify injury patterns of patients with BCVI that are not currently recommended screening criteria. Our prospective BCVI database, initiated in 1997, was queried through December 2010. Indications for screening, injury mechanism, and outcomes were analyzed. Patients younger than 18 years were excluded. During the 14-year study period, 585 BCVIs were identified in 418 patients (66% men; age, 40 years ± 0.7 years). Eighty-three (20%) patients with BCVI did not have standard screening criteria; 66% were asymptomatic at diagnosis. Injury patterns in these patients included mandible fracture (27 patients), complex skull fractures (21 patients), traumatic brain injury with thoracic trauma (6 patients), scalp degloving (6 patients), and great vessel or cardiac injuries (4 patients). Other injuries (11 patients) and no injuries (8 patients) were identified in th...Continue Reading

References

Aug 1, 1990·The Journal of Trauma·T C FabianK A Kudsk
Feb 1, 1988·Journal of Neurosurgery·B MokriO W Houser
Mar 1, 1980·Annals of Surgery·L P Krajewski, N R Hertzer
Sep 1, 1994·The Journal of Trauma·T H CogbillM G Ochsner
May 1, 1996·Annals of Surgery·T C FabianF E Pritchard
Nov 24, 1999·The Journal of Trauma·W L BifflJ M Burch
Feb 12, 2000·American Journal of Surgery·W L BifflJ M Burch
Sep 28, 2002·The Journal of Trauma·Elaine C McKevittRichard K Simons
Jun 16, 2004·Archives of Surgery·John C MayberryGeorge C Velmahos
Nov 26, 2005·American Journal of Surgery·C Clay CothrenJon M Burch
Nov 23, 2006·Journal of the American College of Surgeons·Garth H UtterGregory J Jurkovich
Feb 22, 2008·AJR. American Journal of Roentgenology·Clint W SlikerStuart E Mirvis
May 8, 2008·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Antonia HippRich Sinert
Jan 10, 2009·The Journal of Trauma·Deborah M SteinThomas M Scalea
Sep 11, 2009·The Journal of Trauma·Alexander L EastmanJoseph P Minei
Dec 4, 2009·Journal of Vascular Surgery·John D BerneScott H Norwood

❮ Previous
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Citations

Aug 3, 2016·The Laryngoscope·Gregory KeltsCecelia E Schmalbach
Nov 11, 2014·Radiographics : a Review Publication of the Radiological Society of North America, Inc·David DreizinFelipe Munera
Sep 3, 2016·World Journal of Emergency Surgery : WJES·Alan L BealGreg A Beilman
Oct 31, 2013·ANZ Journal of Surgery·Andrei M Beliaev, Ian Civil
Nov 27, 2014·AJNR. American Journal of Neuroradiology·M WintermarkUNKNOWN American College of Radiology Head Injury Institute
Apr 8, 2014·Journal of Neurosurgery·Paul M ForemanMark R Harrigan
Jun 15, 2016·Journal of Neurotrauma·Vijay M RavindraJay Riva-Cambrin
Jan 7, 2016·Sports Health·Teena ShettyApostolos John Tsiouris
Mar 13, 2018·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Aaron M RutmanMahmud Mossa-Basha
Dec 23, 2017·World Journal of Surgery·Christian D WeberUNKNOWN TraumaRegister DGU
Feb 27, 2018·Emergency Radiology·Cassandra JeavonsMartin L Gunn
Oct 14, 2017·AJNR. American Journal of Neuroradiology·P NagpalD Skeete
Mar 21, 2013·Insights Into Imaging·Matteo BonattiGiampietro Bonatti
Sep 5, 2018·The Journal of Bone and Joint Surgery. American Volume·Daniel G TobertAndrew J Schoenfeld
Aug 4, 2018·Journal of Neurosurgery. Spine·Joshua D BurksBradley N Bohnstedt
Apr 17, 2015·Emergency Radiology·Nupur VermaKen F Linnau
Aug 28, 2019·The Journal of Trauma and Acute Care Surgery·Joshua J SumislawskiClay Cothren Burlew
Oct 29, 2019·The Journal of Trauma and Acute Care Surgery·Christopher W MarencoMatthew J Martin
Oct 19, 2019·The Journal of Trauma and Acute Care Surgery·Areg GrigorianJeffry Nahmias
Dec 2, 2019·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Nasim AhmedKayvon Haghighi
Aug 20, 2014·Craniomaxillofacial Trauma & Reconstruction·Thomas S LeeDavid Stroman
Nov 10, 2017·Neurology·Lori C Jordan, Pratik D Bhattacharya
Sep 7, 2017·Current Opinion in Otolaryngology & Head and Neck Surgery·Elisa IllingCecelia E Schmalbach
Mar 17, 2020·Canadian Association of Radiologists Journal = Journal L'Association Canadienne Des Radiologistes·Rawan Abu MughliSavvas Nicolaou
Oct 1, 2020·The American Surgeon·Ashley Farhat-SabetDeborah Stein
Sep 29, 2015·World Journal of Emergency Surgery : WJES·Lewis E JacobsonArgenis J Herrera
Oct 17, 2017·Frontiers in Surgery·Georgios KaraolanisSotiris Georgopoulos
Oct 31, 2018·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Tor BrommelandElisabeth Jeppesen
Jul 8, 2015·The Journal of Trauma and Acute Care Surgery·Margaret H LauermanDeborah M Stein
Apr 2, 2020·AJR. American Journal of Roentgenology·Nicholas M BeckmannO Clark West
Jun 24, 2017·The Journal of Trauma and Acute Care Surgery·Mackenzie R CookJoseph Cuschieri
Aug 12, 2018·Emergency Radiology·Elizabeth GeorgeBharti Khurana
Sep 29, 2020·Trauma Surgery & Acute Care Open·Michelle K McNuttLillian S Kao
Jul 13, 2018·World Journal of Emergency Surgery : WJES·Vincent P AntoJason L Sperry
Oct 26, 2018·Current Neurology and Neuroscience Reports·David K StoneChristina A Wilson
May 28, 2019·The Journal of Trauma and Acute Care Surgery·Erika FlashburgForrest B Fernandez

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