Time to stroke: A Western Trauma Association multicenter study of blunt cerebrovascular injuries

The Journal of Trauma and Acute Care Surgery
Clay Cothren BurlewMitchell J Cohen

Abstract

Screening for blunt cerebrovascular injuries (BCVIs) in asymptomatic high-risk patients has become routine. To date, the length of this asymptomatic period has not been defined. Determining the time to stroke could impact therapy including earlier initiation of antithrombotics in multiply injured patients. The purpose of this study was to determine the time to stroke in patients with a BCVI-related stroke. We hypothesized that the majority of patients suffer stroke between 24 hours and 72 hours after injury. Patients with a BCVI-related stroke from January 2007 to January 2017 from 37 trauma centers were reviewed. During the 10-year study, 492 patients had a BCVI-related stroke; the majority were men (61%), with a median age of 39 years and ISS of 29. Stroke was present at admission in 182 patients (37%) and occurred during an Interventional Radiology procedure in six patients. In the remaining 304 patients, stroke was identified a median of 48 hours after admission: 53 hours in the 144 patients identified by neurologic symptoms and 42 hours in the 160 patients without a neurologic examination and an incidental stroke identified on imaging. Of those patients with neurologic symptoms, 88 (61%) had a stroke within 72 hours, where...Continue Reading

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Citations

Aug 11, 2018·AJNR. American Journal of Neuroradiology·P NagpalD Skeete
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
Dec 12, 2019·Stroke; a Journal of Cerebral Circulation·Mark R Harrigan
Mar 17, 2020·The Journal of Trauma and Acute Care Surgery·Mark R HarriganJan O Jansen
Apr 7, 2020·The Journal of Trauma and Acute Care Surgery·Kamil HannaBellal Joseph
Oct 26, 2018·Current Neurology and Neuroscience Reports·David K StoneChristina A Wilson
Jun 11, 2020·The Journal of Trauma and Acute Care Surgery·Stefan W LeichtleMichel B Aboutanos
Jan 23, 2021·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Lillie TienJeffrey A Switzer
May 29, 2021·Emergency Radiology·Maxwell E CooperJason W Allen
Jan 23, 2022·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Camille HegoJean-Denis Moyer
Nov 6, 2021·The Journal of Trauma and Acute Care Surgery·Emily C EspositoMargaret H Lauerman

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