Blunt traumatic vascular injuries of the head and neck in the ED

Elizabeth George, Ashish Khandelwal, Christopher Potter, Aaron Sodickson, Srinivasan Mukundan, Diego Nunez, Bharti Khurana

Research output: Contribution to journalReview article

3 Scopus citations

Abstract

Cerebrovascular injury is increasingly identified in patients presenting after blunt trauma due to the implementation of screening criteria and advances in noninvasive angiographic imaging by CT. The variable latent time before onset of secondary stroke presents a window of opportunity for prevention, reinforcing the importance of detection of asymptomatic patients via screening. Furthermore, the high morbidity and mortality associated with secondary stroke makes it imperative that radiologists recognize these challenging injuries. This article reviews the epidemiology of and the various proposed screening criteria for blunt cerebrovascular injury. The imaging findings of extra- and intracranial vascular injuries, including arterial and venous trauma, are reviewed along with the grading system. Conservative management with anticoagulation has gained favor over the years with intervention restricted to high-grade injuries such as transection and hemodynamically significant arteriovenous fistula. Many of these injuries also evolve over time, with or without anticoagulation, necessitating imaging follow-up.

Original languageEnglish (US)
Pages (from-to)75-85
Number of pages11
JournalEmergency Radiology
Volume26
Issue number1
DOIs
StatePublished - Feb 14 2019

Keywords

  • Blunt cerebrovascular injury
  • CT angiography
  • Head and neck
  • Trauma

ASJC Scopus subject areas

  • Emergency Medicine
  • Radiology Nuclear Medicine and imaging

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  • Cite this

    George, E., Khandelwal, A., Potter, C., Sodickson, A., Mukundan, S., Nunez, D., & Khurana, B. (2019). Blunt traumatic vascular injuries of the head and neck in the ED. Emergency Radiology, 26(1), 75-85. https://doi.org/10.1007/s10140-018-1630-y