A multivariate logistic regression analysis of risk factors for blunt cerebrovascular injury

Section: Discussionmentioning

confidence: 99%

Evaluation for Blunt Cerebrovascular Injury: Review of the Literature and a Cost-Effectiveness Analysis

Malhotra¹,

Wu²,

Kalra³

et al. 2015

“…Patients with blunt trauma with a high-velocity mechanism, low Glasgow Coma Scale score, high injury severity score, mandible fracture, complex skull fractures, basilar skull fractures (including carotid canal fractures), scalp degloving, any type of cervical spine injury, traumatic brain injury with thoracic injuries, and/or thoracic vascular imaging are at increased risk for blunt neurovascular injuries (evidence level II). 148,[151][152][153][154] In patients identified as having these types of concurrent injuries, the overall rate of blunt neurovascular injuries increases up to 27%-30%. 147 Although digital subtraction angiography is the diagnostic reference standard for detecting blunt neurovascular injuries, a number of retrospective studies and meta-analyses indicate that multidetector CT angiography is an accurate, rapid, noninvasive diagnostic alternative.…”

Section: Imaging Of Neurovascular Traumamentioning

confidence: 99%

Imaging Evidence and Recommendations for Traumatic Brain Injury: Advanced Neuro- and Neurovascular Imaging Techniques

Wintermark

Sanelli

Anzai

et al. 2014

106

SUMMARY:Neuroimaging plays a critical role in the evaluation of patients with traumatic brain injury, with NCCT as the first-line of imaging for patients with traumatic brain injury and MR imaging being recommended in specific settings. Advanced neuroimaging techniques, including MR imaging DTI, blood oxygen level-dependent fMRI, MR spectroscopy, perfusion imaging, PET/SPECT, and magnetoencephalography, are of particular interest in identifying further injury in patients with traumatic brain injury when conventional NCCT and MR imaging findings are normal, as well as for prognostication in patients with persistent symptoms. These advanced neuroimaging techniques are currently under investigation in an attempt to optimize them and substantiate their clinical relevance in individual patients. However, the data currently available confine their use to the research arena for group comparisons, and there remains insufficient evidence at the time of this writing to conclude that these advanced techniques can be used for routine clinical use at the individual patient level. TBI imaging is a rapidly evolving field, and a number of the recommendations presented will be updated in the future to reflect the advances in medical knowledge. ABBREVIATIONS:BOLD ϭ blood oxygen level-dependent; FA ϭ fractional anisotropy; MD ϭ mean diffusivity; MEG ϭ magnetoencephalography; TBI ϭ traumatic

“…2 Furthermore, patients with accompanying injuries, such as acute cervical spine fracture, basilar skull fracture, major thoracic injury, and mandibular fracture are at risk of vascular injury. 1,3 The diagnosis of cervical vascular injury in patients with trauma or suspected cervical vascular injury is most commonly confirmed with CTA (Fig 1), MR imaging, duplex sonography, and/or conventional angiography. A recent evaluation of CTA with 16-section CT scanners demonstrated a 97.7% sensitivity and 100% specificity compared with the criterion standard of conventional angiography.…”

mentioning

confidence: 99%

Endovascular Repair of Traumatic Cervical Internal Carotid Artery Injuries: A Safe and Effective Treatment Option

Seth

Obuchowski

Zoarski

2012