Abstract:
BACKGROUND:The incidence of traumatic craniocervical artery dissection varies in published trauma series. OBJECTIVE:To determine the frequency of traumatic craniocervical artery injury in polytrauma patients by using standardized whole-body trauma computed tomography with adapted computed tomography angiography of the craniocervical vessels. METHODS:A total of 718 consecutive patients requiring whole-body trauma computed tomography (16-row multislice) because of the mechanism of their injury patterns and an Injury Severity Scale score greater than 16 were analyzed prospectively. After a cranial scan, computed tomography angiography of the craniocervical vessels with 40 mL of iodinated contrast agent was performed using bolus tracking. RESULTS:The overall incidence of blunt carotid and vertebral injuries (BCVIs) in the screened population was 1.7%. BCVIs were observed in 27.3% of patients with detected isolated cervical spine injuries and in 3.9% of patients with isolated cranial fractures with or without intracranial hemorrhage, whereas 5.3% of patients with combined cervical and cranial lesions were associated with BCVIs. In addition, 0.4% of BCVIs occurred in patients without evidence of head or neck trauma. CONCLUSION:Whole-body trauma computed tomography with an adapted scanning protocol for the craniocervical vessels is a fast, safe, and feasible method for detecting vascular injuries. It allows prompt further treatment if necessary. Computed tomography angiography could be a part of a broad screening protocol for craniocervical vessels in documented injuries of the head and neck and in trauma mechanisms influencing the craniocervical region as well.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Fleck SK,Langner S,Baldauf J,Kirsch M,Kohlmann T,Schroeder HWdoi
10.1227/NEU.0b013e31821a8701subject
Has Abstractpub_date
2011-09-01 00:00:00pages
615-23; discussion 623-4issue
3eissn
0148-396Xissn
1524-4040journal_volume
69pub_type
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