Multidetector CT Angiography in the Evaluation of Acute Blunt Head and Neck Trauma: A Proposed Acute Craniocervical Trauma Scoring System

Almandoz, J Delgado; Schaefer, Pamela W.; Kelly, Hillary R.; Lev, Michael H.; González, R. Gilberto; Romero, Javier

doi:10.1148/radiol.09090693

Cited by 34 publications

(6 citation statements)

References 23 publications

(58 reference statements)

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“…The invention and refinement of spiral and multidetector CT were required prior to the gradual elimination of conventional angiography for aortic (187), head and neck (188,189), and peripheral arterial injury (190,191). Although artifacts related to cardiac and aortic pulsation, beam hardening, and breathing challenged aortic assessment (192), early conventional CT was deemed useful in minimizing unnecessary angiography in patients with false-positive chest radiographs, enabling confirmation of the absence of injury in patients at low risk (193)(194)(195).…”

Section: All-in-one Emergency Diagnosis and Triage For The Injuredmentioning

confidence: 99%

Computed Tomography: Revolutionizing the Practice of Medicine for 40 Years

Rubin

2014

Radiology

146

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Computed tomography (CT) has had a profound effect on the practice of medicine. Both the spectrum of clinical applications and the role that CT has played in enhancing the depth of our understanding of disease have been profound. Although almost 90 000 articles on CT have been published in peer-reviewed journals over the past 40 years, fewer than 5% of these have been published in Radiology. Nevertheless, these almost 4000 articles have provided a basis for many important medical advances. By enabling a deepened understanding of anatomy, physiology, and pathology, CT has facilitated key advances in the detection and management of disease. This article celebrates this breadth of scientific discovery and development by examining the impact that CT has had on the diagnosis, characterization, and management of a sampling of major health challenges, including stroke, vascular diseases, cancer, trauma, acute abdominal pain, and diffuse lung diseases, as related to key technical advances in CT and manifested in Radiology.

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Section: All-in-one Emergency Diagnosis and Triage For The Injuredmentioning

confidence: 99%

Computed Tomography: Revolutionizing the Practice of Medicine for 40 Years

Rubin

2014

Radiology

146

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“…This study is still a retrospective, single-patient cohort study that relies heavily on radiographic findings and requires further future validation (Table II). 12 Based on our own risk factor study, we have liberalized screening at our institution to include patients with several "soft" risk factors, with low GCS and high injury severity score (ISS) being the most important, which pan out on a multivariate logistic regression analysis. Some of the patients with BCVIs in our series, including this patient, would have been missed if only the Denver criteria had been used (Table III).…”

Section: Discussionmentioning

confidence: 99%

Bilateral internal carotid and vertebral artery dissection after a horse-riding injury

Keilani

Berne

Agko

2010

Journal of Vascular Surgery

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Blunt cerebrovascular injuries, defined as blunt injuries to the internal carotid or vertebral arteries, are uncommon and usually occur in victims of high-speed deceleration motor vehicle crashes. A blunt cerebrovascular injury after an equestrian accident is an extremely unusual presentation. In recent years, advances in screening and treatment with pharmacologic anticoagulation before the onset of neurologic symptoms have improved outcomes for these patients. Endovascular stenting and embolization, although unproven, offer a new potential approach for these complex injuries. We present a unique case of four-vessel blunt cerebrovascular injuries after a horse-riding injury that required multidisciplinary management.

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“…We considered high-speed motor vehicle accidents (MVAs), strikes by pedestrians/ bicyclists, falls from heights or stairs, and high-force direct blows to the head or neck as high-impact MOIs, and hangings/strangulations, low speed MVAs, and falls from standing as low-impact MOIs (22). Treatment was also classified into conservative treatment or operation.…”

Section: Image Analysismentioning

confidence: 99%

The Secondary Contiguous or Non-contiguous Subchondral Bone Impactions in Subaxial Cervical Spinal Injury: Incidence and Associated Primary Injury Patterns

Han

Kim

Yoon

et al. 2014

J Korean Soc Magn Reson Med

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Purpose :To evaluate the incidence of secondary contiguous or non-contiguous subchondral bone impactions (SBI) in subaxial cervical spinal injury and associated primary injury patterns. Materials and Methods:A retrospective review of computed tomography, magnetic resonance imaging, and medical records was carried out for 47 patients who had sustained a subaxial cervical spinal injury. Presence, number, level, and sites of secondary contiguous or non-contiguous SBI were recorded. To evaluate primary injury patterns, the level and number of primary injury sites of subaxial cervical spine injury, injury morphology, anterior/posterior discoligamentous complex (ADC/PDC) injury, posterior ligamentous complex (PLC) injury, spinal cord injury, and mechanism of injury (MOI) were analyzed. Differences in primary injury pattern of subaxial cervical spine injury and MOI between patients with and without SBI, and between contiguous or non-contiguous SBI were analyzed using the Mann-Whitney U test, Pearson's chi square test and Fisher's exact test.Results: Eighteen patients (18/47, 38.29%) had developed contiguous (n=9) or non-contiguous (n=9) SBI, most commonly involving T3 (15/47, 31.91%) and 3 levels (6/18, 33.33%). All SBIs had developed near the anterosuperior region of the body and the superior endplate and were the result of a high-impact MOI. SBIs were statistically significant in association with injury morphology and PLC injury (P=0.001, P=0.009, respectively) at the primary injury site. Non-contiguous SBI was more frequently accompanied by upper cervical spinal injuries in association with PDC injuries, as opposed to contiguous SBI, with statistical significance (P=0.009), while no other statistically significant differences were found. Conclusion

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Multidetector CT Angiography in the Evaluation of Acute Blunt Head and Neck Trauma: A Proposed Acute Craniocervical Trauma Scoring System

Abstract: The proposed acute craniocervical trauma scoring system could be used as a guide to select blunt trauma patients for multidetector CT angiographic evaluation. Future validation of this scoring system is necessary.

Cited by 34 publications

References 23 publications

Computed Tomography: Revolutionizing the Practice of Medicine for 40 Years

Computed Tomography: Revolutionizing the Practice of Medicine for 40 Years

Bilateral internal carotid and vertebral artery dissection after a horse-riding injury

The Secondary Contiguous or Non-contiguous Subchondral Bone Impactions in Subaxial Cervical Spinal Injury: Incidence and Associated Primary Injury Patterns

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