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Blunt cerebrovascular injuries often accompany craniocervical distraction injuries
Researchers found more than 50% of patients with craniocervical distraction injuries who were properly screened also had blunt cerebrovascular injuries, which have the potential to cause more serious brain complications.
A total of 46 consecutive patients with unstable craniocervical distraction injuries (CCDs) were treated operatively at a single level I trauma center from January 1996 to December 2009, among whom 29 had vascular studies that comprised the final study sample.
The researchers retrospectively analyzed the patients’ medical records to obtain data on mechanism, demographics, clinical findings and transcranial Doppler reports. The researchers also analyzed angiography and CT angiography findings to assess for blunt cerebrovascular injuries (BCVIs), which were classified using Biffl criteria if observed.
A total of 30 BCVIs were identified in 15 of the 29 patients. The researchers found 13 grade I injuries, eight grade II injuries, five grade III injuries, three grade IV injuries and one grade V injury based on the Biffl criteria. No strokes were recorded in patients without BCVIs, but three strokes were identified in the 15 patients who presented with a BCVI.
Because of this ratio, the researchers concluded that patients presenting with CCD injuries should be screened for BCVIs. – by Robert Linnehan
Disclosures: Vilela reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.