Blunt cerebrovascular injury: incidence and long-term follow-up

Autor: Willem-Bart M. Slooff, Gert J. de Borst, Quirine M.J. van der Vliet, Nizar Moayeri, Falco Hietbrink, Dennis Hundersmarck, Sander P. J. Muijs, F. C. Oner, Luke P. H. Leenen, Jelle F. Homans
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Adult
Male
medicine.medical_specialty
Computed Tomography Angiography
Critical Care and Intensive Care Medicine
Wounds
Nonpenetrating
03 medical and health sciences
0302 clinical medicine
Blunt
Trauma Centers
Basilar skull fracture
medicine
Humans
Orthopedics and Sports Medicine
Cerebrovascular Trauma
Computed tomography angiography
Aged
Ischemic Stroke
Retrospective Studies
Patient-reported outcomes
Trauma Severity Indices
medicine.diagnostic_test
business.industry
Incidence (epidemiology)
Incidence
Trauma center
Carotid artery injury
Middle Aged
medicine.disease
Polytrauma
Functional outcomes
Cerebral Angiography
Blunt trauma
Vertebral artery injury
Cohort
Emergency Medicine
Quality of Life
030211 gastroenterology & hepatology
Surgery
Original Article
Female
Radiology
business
030217 neurology & neurosurgery
Blunt cerebrovascular injury
Follow-Up Studies
Zdroj: European Journal of Trauma and Emergency Surgery
ISSN: 1863-9941
1863-9933
Popis: Purpose Blunt cerebrovascular injuries (BCVI), which can result in ischemic stroke, are identified in 1–2% of all blunt trauma patients. Computed tomography angiography (CTA) scanning has improved and is the diagnostic modality of choice in BCVI suspected patients. Data about long-term functional outcomes and the incidence of ischemic stroke after BCVI are limited. The aim of this study was to determine BCVI incidence in relation to imaging modality improvements and to determine long-term functional outcomes. Methods All consecutive trauma patients from 2007 to 2016 with BCVI were identified from the level 1 trauma center prospective trauma database. Three periods were identified where CTA diagnostic modalities for trauma patients were improved. Long-term functional outcomes using the EuroQol six-dimensional (EQ-6D™) were determined. Results Seventy-one BCVI patients were identified among the 12.122 (0.59%) blunt trauma patients. In the first period BCVI incidence among the overall study cohort, polytrauma, basilar skull fracture and cervical trauma subgroups was found to be 0.3%, 0.9%, 1.2%, 4.6%, respectively, which more than doubled towards the third period (0.8, 2.4, 1.9 and 8.5% respectively). Ischemic stroke as a result of BCVI was found in 20 patients (28%). In-hospital stroke rate was lower in patients receiving antiplatelet therapy (p p Conclusions Improved CTA diagnostic modalities have increased BCVI incidence. Furthermore, BCVI patients reported significant functional impairment at long-term follow-up. Antiplatelet therapy showed a significant effect on in-hospital stroke rate reduction.
Databáze: OpenAIRE
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