Cervical Arterial Injury After Blunt Trauma in Children

Tolhurst, Stephen R.; Vanderhave, Kelly L.; Caird, Michelle S.; Garton, Hugh L.; Graziano, Gregory P.; Maher, Cormac O.; Hensinger, Robert N.; Farley, Frances A.

doi:10.1097/bpo.0b013e3182670392

Cited by 15 publications

(15 citation statements)

References 28 publications

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“…Several authors have demonstrated that BCVI do occur in traumatized children and that the incidence may be as high as in adults [ 28 , 50 , 51 ]. An attempt to create a pediatric screening tool in order to minimize the use of radiation exposure from CT angiography (CTA) has also been made [ 52 , 53 ].…”

Section: Resultsmentioning

confidence: 99%

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Best practice guidelines for blunt cerebrovascular injury (BCVI)

Brommeland

Helseth

Aarhus

et al. 2018

Scand J Trauma Resusc Emerg Med

106

126

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Blunt cerebrovascular injury (BCVI) is a non-penetrating injury to the carotid and/or vertebral artery that may cause stroke in trauma patients. Historically BCVI has been considered rare but more recent publications indicate an overall incidence of 1–2% in the in-hospital trauma population and as high as 9% in patients with severe head injury. The indications for screening, treatment and follow-up of these patients have been controversial for years with few clear recommendations. In an attempt to provide a clinically oriented guideline for the handling of BCVI patients a working committee was created. The current guideline is the end result of this committees work. It is based on a systematic literature search and critical review of all available publications in addition to a standardized consensus process. We recommend using the expanded Denver screening criteria and CT angiography (CTA) for the detection of BCVI. Early antithrombotic treatment should be commenced as soon as considered safe and continued for at least 3 months. A CTA at 7 days to confirm or discard the diagnosis as well as a final imaging control at 3 months should be performed.Electronic supplementary materialThe online version of this article (10.1186/s13049-018-0559-1) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

“…LMWH may be continued throughout the entire treatment period, but oral antiplatelets should be used if feasible. We recommend low dose ASA (75 mg × 1) as this oral antiplatelet is readily available, cheap, easily administered even in children and as effective as a higher dose ASA in stroke prevention [ 50 , 68 , 79 ].…”

Section: Resultsmentioning

confidence: 99%

Best practice guidelines for blunt cerebrovascular injury (BCVI)

Brommeland

Helseth

Aarhus

et al. 2018

Scand J Trauma Resusc Emerg Med

106

126

View full text Add to dashboard Cite

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“…MRI can identify vascular intramural hematomas and early ischemic spinal cord injuries and thus identify patients who may benefit from additional vascular imaging and management of ischemic complications [68]. Disadvantages include lengthy examination times in an environment where patient monitoring can be difficult.…”

Section: Discussion Of Procedures By Variantmentioning

confidence: 99%

“…There are currently no sufficient reports regarding outcomes of vascular imaging in children with spinal trauma. Cervical vascular injury in pediatric blunt trauma can be seen in 11.5% of pediatric patients [68]. CT angiography (CTA) has been validated against digital subtraction angiography (DSA) for imaging of cerebrovascular injury in adults, but DSA remains the reference standard [68].…”

Section: Discussion Of Procedures By Variantmentioning

confidence: 99%

ACR Appropriateness Criteria® Suspected Spine Trauma-Child

Kadom

Palasis

Pruthi

et al. 2019

Journal of the American College of Radiology

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Choosing the appropriate imaging in children with accidental traumatic spine injuries can be challenging because the recommendations based on scientific evidence at this time differ from those applied in adults. This differentiation is due in part to differences in anatomy and physiology of the developing spine. This publication uses scientific evidence and a panel of pediatric experts to summarize best current imaging practices for children with accidental spine trauma.

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“…Although uncommonly reported in children, TBI may be associated with vascular injuries, including arterial injury at the skull base or in the cervical region. 32,33 Vascular imaging should be considered when there is concern for arterial or venous injury or when a fracture extends through vascular channels of the skull base. 34 Noninvasive imaging with CT angiography (CTA) or MR angiography (MRA) has become the first-line imaging for arterial injury.…”

Section: The Evolving Role Of Mri In Acute Pediatric Tbimentioning

confidence: 99%

Use of Conventional and Advanced MRI Techniques in Accidental Pediatric Traumatic Brain Injury

Mendoza

Kadom

Palasis

et al. 2016

J Pediatr Neuroradiol

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Traumatic brain injury (TBI) has a complex and dynamic pathophysiology, and neuroimaging plays a critical role in its evaluation in the acute, subacute, and chronic settings. Here, we describe technical advancements in magnetic resonance (MR) imaging techniques that promote use of MRI for acute TBI in children to avoid radiation exposure. We also discuss the value of using advanced MR imaging techniques for research in children with TBI.

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Cervical Arterial Injury After Blunt Trauma in Children

Abstract: Level IV-retrospective diagnostic study.

Cited by 15 publications

References 28 publications

Best practice guidelines for blunt cerebrovascular injury (BCVI)

Best practice guidelines for blunt cerebrovascular injury (BCVI)

ACR Appropriateness Criteria® Suspected Spine Trauma-Child

Use of Conventional and Advanced MRI Techniques in Accidental Pediatric Traumatic Brain Injury

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