Scientific PapersOptimizing screening for blunt cerebrovascular injuries
Section snippets
Patients
Denver Health Medical Center is a certified urban level I trauma center with pediatric commitment, and serves as the Rocky Mountain regional trauma center for Colorado and adjoining regions. The number of trauma admissions during the study period (January 1990 through September 1998) has been stable at 3000 to 3200 patients per year, and 86% of admissions have resulted from blunt injury. Our trauma registry records patients at the time of their hospitalization, and was employed to identify
Patients
From January 1990 through September 1998, cerebral arteriography was performed in 249 patients to exclude BCVI; 85 (34%) were diagnosed with injuries. Sixty-five patients had carotid injuries, 10 had vertebral injuries, and 10 had both carotid and vertebral injuries. Carotid injuries were bilateral in 32 patients, and vertebral injuries bilateral in 5. Forty patients initially presented with signs or symptoms of BCVI; 28 (70%) had injuries. Among 209 asymptomatic patients, we diagnosed injuries
Comments
Blunt cerebrovascular injuries (BCVI) have the potential for devastating complications. Early reports collectively established mortality rates of BCI to be 28%, with 58% of survivors suffering severe neurologic sequelae.1, 2, 3 Subsequent multicenter reviews corroborated these disconcerting morbidity and mortality figures, and identified the incidence of BCI to be 0.08% to 0.17% among patients admitted to trauma centers following blunt injury.4, 5, 6, 7 Based on our involvement in one such
References (20)
- et al.
Blunt trauma to the carotid arteries
J Vasc Surg
(1991) - et al.
Carotid artery traumaa review of contemporary trauma center experiences
J Vasc Surg
(1995) - et al.
Carotid artery occlusion due to nonpenetrating injury
J Trauma
(1967) - et al.
Blunt carotid artery traumareport of two cases and review of the literature
Ann Surg
(1980) - et al.
Carotid artery injuries caused by blunt trauma
Ann Surg
(1980) - et al.
Blunt carotid artery dissectionincidence, associated injuries, screening, and treatment
J Trauma
(1990) - et al.
The spectrum of blunt injury to the carotid arterya multicenter perspective
J Trauma
(1994) - et al.
Blunt carotid injuryimportance of early diagnosis and anticoagulant therapy
Ann Surg
(1996) - et al.
Incidence of unsuspected blunt carotid artery injury
Neurosurgery
(1998) - et al.
Traumatic dissections of the extracranial internal carotid artery
J Neurosurg
(1988)
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