scholarly journals Blunt vertebral artery injury in occipital condyle fractures

2018 ◽  
Vol 29 (5) ◽  
pp. 500-505 ◽  
Author(s):  
Joshua D. Burks ◽  
Andrew K. Conner ◽  
Robert G. Briggs ◽  
Phillip A. Bonney ◽  
Adam D. Smitherman ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Blunt Trauma ◽  
Craniocervical Junction ◽  
Vertebral Artery Injury ◽  
Occipital Condyle ◽  
Trauma Patients ◽  
Type I ◽  
Type Iii ◽  
Artery Injury ◽  
Occipital Condyle Fractures

OBJECTIVEA shifting emphasis on efficient utilization of hospital resources has been seen in recent years. However, reduced screening for blunt vertebral artery injury (BVAI) may result in missed diagnoses if risk factors are not fully understood. The authors examined the records of blunt trauma patients with fractures near the craniocervical junction who underwent CTA at a single institution to better understand the risk of BVAI imposed by occipital condyle fractures (OCFs).METHODSThe authors began with a query of their prospectively collected trauma registry to identify patients who had been screened for BVAI using ICD-9-CM diagnostic codes. Grade and segment were recorded in instances of BVAI. Locations of fractures were classified into 3 groups: 1) OCFs, 2) C1 (atlas) fractures, and 3) fractures of the C2–6 vertebrae. Univariate and multivariate analyses were performed to identify any fracture types associated with BVAI.RESULTSDuring a 6-year period, 719 patients underwent head and neck CTA following blunt trauma. Of these patients, 147 (20%) had OCF. BVAI occurred in 2 of 43 patients with type I OCF, 1 of 42 with type II OCF, and in 9 of 62 with type III OCF (p = 0.12). Type III OCF was an independent risk factor for BVAI in multivariate modeling (OR 2.29 [95% CI 1.04–5.04]), as were fractures of C1–6 (OR 5.51 [95% CI 2.57–11.83]). Injury to the V4 segment was associated with type III OCF (p < 0.01).CONCLUSIONSIn this study, the authors found an association between type III OCF and BVAI. While further study may be necessary to elucidate the mechanism of injury in these cases, this association suggests that thorough cerebrovascular evaluation is warranted in patients with type III OCF.

Blunt Cerebrovascular Injuries

2017 ◽  
Author(s):  
Clay Cothren Burlew
Keyword(s):  
Carotid Artery ◽  
Vertebral Artery ◽  
Blunt Trauma ◽  
Computed Tomographic Angiography ◽  
Vertebral Artery Injury ◽  
Trauma Patients ◽  
Carotid Artery Injury ◽  
Computed Tomographic ◽  
Artery Injury ◽  
Asymptomatic Patients

Blunt cerebrovascular injuries (BCVIs) are increasingly recognized in trauma patients, with 1 to 3% of all blunt trauma patients being diagnosed with a carotid artery injury or a vertebral artery injury. Specific injury patterns are associated with BCVI and serve as the trigger for injury screening in asymptomatic patients. Multislice (> 64-slice) computed tomographic angiography is the routine imaging test performed to identify BCVI. Once an injury is identified, antithrombotic treatment almost universally prevents BCVI-related stroke. Endovascular therapy for BCVI is reserved for those patients who are markedly symptomatic or have an enlarging pseudoaneurysm on repeat imaging. Key Words: blunt cerebrovascular injuries, blunt trauma, carotid artery injury, stroke, vertebral artery injury

Blunt Cerebrovascular Injuries

2017 ◽  
Author(s):  
Clay Cothren Burlew
Keyword(s):  
Carotid Artery ◽  
Vertebral Artery ◽  
Blunt Trauma ◽  
Computed Tomographic Angiography ◽  
Vertebral Artery Injury ◽  
Trauma Patients ◽  
Carotid Artery Injury ◽  
Computed Tomographic ◽  
Artery Injury ◽  
Asymptomatic Patients

Blunt cerebrovascular injuries (BCVIs) are increasingly recognized in trauma patients, with 1 to 3% of all blunt trauma patients being diagnosed with a carotid artery injury or a vertebral artery injury. Specific injury patterns are associated with BCVI and serve as the trigger for injury screening in asymptomatic patients. Multislice (> 64-slice) computed tomographic angiography is the routine imaging test performed to identify BCVI. Once an injury is identified, antithrombotic treatment almost universally prevents BCVI-related stroke. Endovascular therapy for BCVI is reserved for those patients who are markedly symptomatic or have an enlarging pseudoaneurysm on repeat imaging. Key Words: blunt cerebrovascular injuries, blunt trauma, carotid artery injury, stroke, vertebral artery injury

Blunt Cerebrovascular Injuries

2017 ◽  
Author(s):  
Clay Cothren Burlew
Keyword(s):  
Carotid Artery ◽  
Vertebral Artery ◽  
Blunt Trauma ◽  
Computed Tomographic Angiography ◽  
Vertebral Artery Injury ◽  
Trauma Patients ◽  
Carotid Artery Injury ◽  
Computed Tomographic ◽  
Artery Injury ◽  
Asymptomatic Patients

Blunt cerebrovascular injuries (BCVIs) are increasingly recognized in trauma patients, with 1 to 3% of all blunt trauma patients being diagnosed with a carotid artery injury or a vertebral artery injury. Specific injury patterns are associated with BCVI and serve as the trigger for injury screening in asymptomatic patients. Multislice (> 64-slice) computed tomographic angiography is the routine imaging test performed to identify BCVI. Once an injury is identified, antithrombotic treatment almost universally prevents BCVI-related stroke. Endovascular therapy for BCVI is reserved for those patients who are markedly symptomatic or have an enlarging pseudoaneurysm on repeat imaging. Key Words: blunt cerebrovascular injuries, blunt trauma, carotid artery injury, stroke, vertebral artery injury

Blunt Cerebrovascular Injuries

2017 ◽  
Author(s):  
Clay Cothren Burlew
Keyword(s):  
Carotid Artery ◽  
Vertebral Artery ◽  
Blunt Trauma ◽  
Computed Tomographic Angiography ◽  
Vertebral Artery Injury ◽  
Trauma Patients ◽  
Carotid Artery Injury ◽  
Computed Tomographic ◽  
Artery Injury ◽  
Asymptomatic Patients

Blunt cerebrovascular injuries (BCVIs) are increasingly recognized in trauma patients, with 1 to 3% of all blunt trauma patients being diagnosed with a carotid artery injury or a vertebral artery injury. Specific injury patterns are associated with BCVI and serve as the trigger for injury screening in asymptomatic patients. Multislice (> 64-slice) computed tomographic angiography is the routine imaging test performed to identify BCVI. Once an injury is identified, antithrombotic treatment almost universally prevents BCVI-related stroke. Endovascular therapy for BCVI is reserved for those patients who are markedly symptomatic or have an enlarging pseudoaneurysm on repeat imaging. Key Words: blunt cerebrovascular injuries, blunt trauma, carotid artery injury, stroke, vertebral artery injury

Blunt Cerebrovascular Injuries

2017 ◽  
Author(s):  
Clay Cothren Burlew
Keyword(s):  
Carotid Artery ◽  
Vertebral Artery ◽  
Blunt Trauma ◽  
Computed Tomographic Angiography ◽  
Vertebral Artery Injury ◽  
Trauma Patients ◽  
Carotid Artery Injury ◽  
Computed Tomographic ◽  
Artery Injury ◽  
Asymptomatic Patients

Blunt cerebrovascular injuries (BCVIs) are increasingly recognized in trauma patients, with 1 to 3% of all blunt trauma patients being diagnosed with a carotid artery injury or a vertebral artery injury. Specific injury patterns are associated with BCVI and serve as the trigger for injury screening in asymptomatic patients. Multislice (> 64-slice) computed tomographic angiography is the routine imaging test performed to identify BCVI. Once an injury is identified, antithrombotic treatment almost universally prevents BCVI-related stroke. Endovascular therapy for BCVI is reserved for those patients who are markedly symptomatic or have an enlarging pseudoaneurysm on repeat imaging. Key Words: blunt cerebrovascular injuries, blunt trauma, carotid artery injury, stroke, vertebral artery injury

Type III occipital condylar fracture presenting with hydrocephalus, vertebral artery injury and vasospasm: case report

2001 ◽  
Vol 43 (3) ◽  
pp. 246-248 ◽  
Author(s):  
J. A. Menéndez ◽  
Mustafa K. Başkaya ◽  
M. A. Day ◽  
A. Nanda
Keyword(s):  
Case Report ◽  
Vertebral Artery ◽  
Vertebral Artery Injury ◽  
Condylar Fracture ◽  
Type Iii ◽  
Artery Injury

scholarly journals Vertebral artery injury in major trauma patients in Saudi Arabia: A retrospective cohort study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Sharfuddin Chowdhury ◽  
Sadiq Hussain Almubarak ◽  
Khadega Hadi Binsaad ◽  
Biswadev Mitra ◽  
Mark Fitzgerald
Keyword(s):  
Saudi Arabia ◽  
Vertebral Artery ◽  
Major Trauma ◽  
Vertebral Artery Injury ◽  
Trauma Patients ◽  
Artery Injury ◽  
Trauma Service ◽  
Secondary Objective ◽  
Grade Ii ◽  
Polytrauma Patients

Abstract Blunt vertebral artery injury (VAI) is associated with severe cervicocephalic trauma and may have devastating consequences. This study aimed to determine the incidence and nature of VAI in polytrauma patients. The secondary objective was to assess the association of VAI with previously suggested risk factors. It was a retrospective observational study of all polytrauma patients admitted to the trauma unit between April 2018 and July 2019, who had CT neck angiography to diagnose blunt VAI according to modified Denver criteria. Out of 1084 admitted polytrauma patients, 1025 (94.6%) sustained blunt trauma. Of these, 120 (11.7%) underwent screening CT neck angiography. VAI was detected in 10 (8.3%; 95% CI 4.1–14.8) patients. There were three patients with Grade I injury, two with Grade II, and five with Grade IV injury. Among all trauma admissions, the incidence of diagnosed VAI was 0.9% (95% CI 0.5–1.8). Among patients suspected of VAI, there was no univariable association of VAI with C-Spine fracture: OR 4.2 (95% CI 0.51–34.4; p = 0.18). There were two (20%) deaths related to VAI. Traumatic VAI was uncommonly detected in this major trauma service in Saudi Arabia. High suspicion and liberal screening by CT angiography in cases where VAI is possible should be considered to avoid missed injuries.

Abstract TP444: New Ischemic Lesions on Brain MRI in Patients With Blunt Traumatic Cerebrovascular Injury

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Mark Harrigan ◽  
Russell Griffin ◽  
John Deveikis ◽  
Veeranjaneyulu Prattipati ◽  
Marc Chimowitz ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Blunt Trauma ◽  
Negative Binomial ◽  
Brain Mri ◽  
Brain Magnetic Resonance Imaging ◽  
The United States ◽  
High Energy ◽  
Trauma Patients ◽  
Cerebrovascular Injury ◽  
Artery Injury

Introduction: Patients admitted after high energy blunt trauma with extracranial cerebrovascular injuries on screening neck computed tomography angiography (CTA) represent a unique group of patients at risk of thromboembolic stroke. These arterial dissections account for >1,000 ischemic strokes in the United States per year. Although stroke prophylaxis with antithrombotics is widely used in this setting, the risk of ischemic brain injury is unknown. Methods: This prospective observational study included 20 adult blunt trauma patients admitted with a screening CTA showing extracranial carotid or vertebral artery injury. All subjects had no initial clinical evidence of ischemic stroke, were managed with antiplatelets and observation and had brain magnetic resonance imaging (MRI) within 14 days of admission. The MRIs included diffusion, susceptibility, and FLAIR sequences to distinguish acute ischemic lesions from contusions and chronic infarctions and were read by two neuroradiologists blind to the findings of the neck CTA. A negative binomial regression adjusted for age and Injury Severity Score (ISS) was used to assess association between artery injury and lesion counts. Results: There were 12 carotid injuries and 11 unilateral or bilateral vertebral artery injuries. Mean interval between injury and MRI scan was 6.9 days. New ischemic lesions in the territory of the affected artery were present in 10 (43%) of the injured artery territories. The mean number of ischemic lesions was 7.8 (range 2-25), which was higher for territories with artery injury (mean=3.17) than those without injury (mean=0.14). None of the lesions were symptomatic. Adjusted for age and ISS, those with artery injury had a 23-fold higher average count of lesions (p=0.0004). In a sensitivity analysis excluding lesion counts >1.5 standard deviation units, the association remained 11-fold higher count for artery injury (p=0.0107). Conclusions: In blunt trauma patients with CTA evidence of extracranial cerebrovascular injury and treated with antiplatelets, >40% of arterial injuries are associated with ischemic lesions on MRI. Ischemic lesions on MRI may be a useful endpoint for future clinical trials of antithrombotic strategies in patients with blunt cerebrovascular injury.

Vertebral Artery Injury after Blunt Trauma without Concomitant Cervical or Neurologic Injuries: A Screening Conundrum

2011 ◽  
Vol 77 (4) ◽  
pp. 72-73
Author(s):  
Brenda M. Kopriva ◽  
R. Stephen Smith ◽  
Christine L. Yates ◽  
Stephen D. Helmer
Keyword(s):  
Vertebral Artery ◽  
Blunt Trauma ◽  
Vertebral Artery Injury ◽  
Artery Injury
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