keyword
https://read.qxmd.com/read/38492727/stroke-prevention-in-blunt-cerebrovascular-injury-role-of-aspirin-81-mg
#1
JOURNAL ARTICLE
Sina Asaadi, Christopher B Khoury, Julia Han, Martin G Rosenthal, Allen G Murga, Justin Dye, Kaushik Mukherjee, Miguel Lopez-Gonzalez, Ian Kershisnik, Marie L Crandall, Maryam B Tabrizi
BACKGROUND: The stroke rate in blunt cerebrovascular injury (BCVI) varies from 25% without treatment to less than 8% with antithrombotic therapy (ATT). There is no consensus on the optimal management to prevent stroke BCVI. We investigated the efficacy and safety of oral Aspirin (ASA) 81 mg to prevent BCVI-related stroke compared to historically reported stroke rates with ASA 325 mg and heparin. METHOD: A single-center retrospective study included adult trauma patients who received oral ASA 81 mg for BCVI management between 2013 and 2022...
March 14, 2024: Annals of Vascular Surgery
https://read.qxmd.com/read/38449976/bilateral-blunt-traumatic-dissections-of-the-extracranial-internal-carotid-artery-a-case-report-and-literature-review
#2
Yahya H Khormi, Atheer I Darraj, Alshaymaa Arishy, Seham O Abuzahirah, Mostafa Atteya
Bilateral traumatic dissections of the cervical internal carotid artery (ICA) are rare complications of polytrauma. A thorough literature review was performed, and data from selected studies were analyzed to assess the trends in clinical presentation, modes of trauma, management protocols, and clinical outcomes. The reported outcomes were categorized and graded into optimal, intermediate, and poor outcomes. We describe a rare case of bilateral dissection of ICA in a 31-year-old woman who was involved in a motor vehicle accident...
February 2024: Curēus
https://read.qxmd.com/read/38447283/risk-factors-for-blunt-cerebrovascular-injury-in-a-cohort-of-pediatric-patients-with-cervical-seat-belt-sign
#3
JOURNAL ARTICLE
Daniel A Najar, Marylou Cardenas-Turanzas, Jadeyn King, Manish N Shah, Charles S Cox, Irma T Ugalde
BACKGROUND: Three-point seat belt restraints have been attributed to blunt cerebrovascular injury (BVCI), injury to the carotid or vertebral arteries. Although previous studies have not found a seat belt sign to be a significant predictor for BCVI, it is still used to screen patients for BCVI. OBJECTIVE: This study aims to determine risk factors for BCVI within a cohort of patients with seat belt signs. METHODS: We conducted a retrospective cohort study using our institutional trauma registry and included patients younger than 18 years with blunt trauma who both had a computed tomography angiography (CTA) of the neck performed and had evidence of a seat belt sign per the medical record...
March 7, 2024: Pediatric Emergency Care
https://read.qxmd.com/read/38336211/stenting-for-traumatic-pseudoaneurysms-of-the-cervical-internal-carotid-artery-case-report-and-systematic-review
#4
JOURNAL ARTICLE
Andre A Payman, Nathan C Pecoraro, John T Tsiang, John Souter, Robert Hand, Carlos F Bechara, Joseph C Serrone
BACKGROUND: The optimal stenting approach for traumatic pseudoaneurysms (PSA) of the extracranial internal carotid artery (ICA) remains underinvestigated. We present a case of a traumatic pseudoaneurysm of the extracranial ICA managed with stenting and review of prior published similar cases. METHODS: The systematic review followed PRISMA-S guidelines and included studies that investigated traumatic pseudoaneurysms of the extracranial ICA managed by stent placement...
February 7, 2024: World Neurosurgery
https://read.qxmd.com/read/38277875/prognostic-factors-associated-with-risk-of-stroke-following-blunt-cerebrovascular-injury-a-systematic-review-and-meta-analysis
#5
JOURNAL ARTICLE
Alexandre Tran, Shannon M Fernando, Bram Rochwerg, Harvey Hawes, Morad S Hameed, Phillip Dawe, Naisan Garraway, David C Evans, Dennis Kim, Walter L Biffl, Kenji Inaba, Paul T Engels, Kelly Vogt, Dalibor Kubelik, Andrew Petrosoniak, Emilie Joos
BACKGROUND & OBJECTIVES: Blunt cerebrovascular injury (BCVI) includes carotid and/or vertebral artery injury following trauma, and conveys an increased stroke risk. We conducted a systematic review and meta-analysis to provide a comprehensive summary of prognostic factors associated with risk of stroke following BCVI. METHODS: We searched the EMBASE and MEDLINE databases from January 1946 to June 2023. We identified studies reporting associations between patient or injury factors and risk of stroke following BCVI...
March 2024: Injury
https://read.qxmd.com/read/38110079/analysis-of-extracranial-cerebrovascular-injuries-clinical-predictors-of-management-and-outcomes
#6
JOURNAL ARTICLE
Hans K Boggs, Sharon C Kiang, Zachary Tran, Kaushik Mukherjee, Roger T Tomihama
OBJECTIVE: Optimal management of traumatic extracranial cerebrovascular injuries (ECVI) remains undefined. We sought to evaluate the factors that influence management, and neurologic outcomes (stroke and brain death) following traumatic ECVI. METHOD: A retrospective review of a single level 1 trauma center's prospectively maintained data registry of patients older than 18 years of age with a diagnosis of ECVI was performed from 2013-2019. Injuries limited to the external carotid artery were excluded...
December 16, 2023: Annals of Vascular Surgery
https://read.qxmd.com/read/38106347/hybrid-repair-of-an-innominate-artery-pseudoaneurysm-after-blunt-traumatic-injury-in-a-bovine-arch
#7
Keyuree Satam, Sabina Sorondo, Michael Paisley, Venita Chandra
Innominate artery injury is an uncommon consequence of blunt trauma to the neck due to its protected position behind the thorax. A 38-year-old male presented as a trauma with a right-sided pseudoaneurysm emanating from the distal innominate artery after falling from a three-story building. On imaging, he also had a bovine arch. He underwent hybrid repair with covered stent placement from the common carotid into the innominate artery, carotid-subclavian bypass, and plugging of the subclavian artery. The patient recovered with no cerebral insult, neurological deficits, or rupture...
December 2023: Journal of Vascular Surgery Cases and Innovative Techniques
https://read.qxmd.com/read/38061238/blunt-cerebrovascular-injury-complications-in-aging-adults-a-national-trauma-database-study
#8
JOURNAL ARTICLE
Rosa Negash, Holly Baselice, Shruthi Srinivas, Mehak Chawla, Andrew J Young
INTRODUCTION: Blunt cerebrovascular injury (BCVI) is defined as a nonpenetrating injury to the carotid or vertebral arteries which can be highly morbid. Because BCVI is rare, most studies have been devoted to triaging trauma patients for BCVI identification, with little data available regarding the complications these patients experience after initial evaluation. Here, we analyze the association of complications during admission for BCVI patients. METHODS: The National Trauma Databank was queried from 2007 to 2014 for adults ≥65 y old...
December 6, 2023: Journal of Surgical Research
https://read.qxmd.com/read/37869052/endovascular-treatment-of-vascular-injuries-in-the-craniocervical-region-with-a-graft-stent-a-single-center-experience
#9
JOURNAL ARTICLE
Anıl Tanburoglu, Cagatay Andic
AIM: We aimed to evaluate the efficacy and safety of graft stent implantation in the endovascular treatment of vascular injuries in the craniocervical area. MATERIALS AND METHODS: This study was carried out through the retrospective screening of eight (two females and six males) patients' records. Patients who used graft stents as an endovascular method were included in the study. The mean age of the patients was 43.6 years (with a range of 15-69 years). Due to different mechanisms, the patients had vascular injuries in the craniocervical region, and graft stent implantation was performed between 2010 and 2022...
October 2023: Curēus
https://read.qxmd.com/read/37840971/surgical-treatment-of-extracranial-internal-carotid-artery-pseudoaneurysm-in-an-infant-due-to-falling-from-height-an-unusual-case
#10
Erhan Renan Ucaroglu, Mehmet Tahtabasi
Pseudoaneurysms of the internal carotid artery (ICA) caused by non-penetrating trauma are extremely rare. Patients with ICA pseudoaneurysms may present with cerebral ischemia, cervical masses, neck swelling, hematoma, rupture, pain, or cranial nerve dysfunction. We present a case of a left ICA pseudoaneurysm that developed in a 7-month-old infant because of a fall from height. The patient developed left-sided neck swelling that caused severe airway obstruction and respiratory arrest. The patient was urgently intubated and underwent emergency surgery under general anesthesia to repair the defect in the left ICA...
2023: International Medical Case Reports Journal
https://read.qxmd.com/read/37791730/traumatic-cervical-cerebrovascular-injury-and-the-role-of-cta-ajr-expert-panel-narrative-review
#11
REVIEW
Arindam Rano Chatterjee, Ajay Malhotra, Patti Curl, Jalal B Andre, Gloria J Guzman Perez-Carrillo, Elana B Smith
Traumatic cerebrovascular injury (CVI) involving the cervical carotid and vertebral arteries is rare but can lead to stroke, hemodynamic compromise, and mortality in the absence of early diagnosis and treatment. The diagnosis of both blunt CVI (BCVI) and penetrating CVI is based on cerebrovascular imaging. The most commonly used screening criteria for BCVI include the expanded Denver criteria and the Memphis criteria, each providing varying thresholds for subsequent imaging. Neck CTA has supplanted catheter-based digital subtraction angiography as the preferred screening modality for CVI in patients with trauma...
October 4, 2023: AJR. American Journal of Roentgenology
https://read.qxmd.com/read/37760850/neuroendovascular-surgery-applications-in-craniocervical-trauma
#12
REVIEW
Michael Kim, Galadu Subah, Jared Cooper, Michael Fortunato, Bridget Nolan, Christian Bowers, Kartik Prabhakaran, Rolla Nuoman, Krishna Amuluru, Sauson Soldozy, Alvin S Das, Robert W Regenhardt, Saef Izzy, Chirag Gandhi, Fawaz Al-Mufti
Cerebrovascular injuries resulting from blunt or penetrating trauma to the head and neck often lead to local hemorrhage and stroke. These injuries present with a wide range of manifestations, including carotid or vertebral artery dissection, pseudoaneurysm, occlusion, transection, arteriovenous fistula, carotid-cavernous fistula, epistaxis, venous sinus thrombosis, and subdural hematoma. A selective review of the literature from 1989 to 2023 was conducted to explore various neuroendovascular surgical techniques for craniocervical trauma...
August 28, 2023: Biomedicines
https://read.qxmd.com/read/37734494/association-between-cervical-fracture-patterns-and-blunt-cerebrovascular-injury-when-screened-with-computed-tomographic-angiography
#13
JOURNAL ARTICLE
Peter Z Du, Nicholas D Christopher, Venkat Ganapathy
BACKGROUND: Prior studies have demonstrated a close association between cervical spine fractures and blunt cerebrovascular injuries (BCVI). Undiagnosed BCVI is a feared complication because of the potentially catastrophic outcomes in a missed posterior circulation stroke. Computed tomography angiography (CTA) is commonly used to screen for BCVI in the trauma setting. However, determining which cervical fracture patterns mandate screening is still not clearly known. PURPOSE: The aim of this retrospective review is to further elucidate which fracture patterns are associated with BCVI when utilizing CTA and may mandate screening...
September 19, 2023: Spine Journal: Official Journal of the North American Spine Society
https://read.qxmd.com/read/37728012/surgeon-modified-fenestrated-stent-grafts-for-zone-2-endovascular-repair-of-blunt-traumatic-thoracic-aortic-injury-early-and-midterm-results
#14
JOURNAL ARTICLE
Levent Mavioglu, Hakki Zafer Iscan, Goktan Askin, Bekir Bogachan Akkaya, Naim Noran Tumer, Mehmet Karahan, Ertekin Utku Unal
AIM: Blunt traumatic thoracic aortic injury (BTAI) is a highly fatal surgical emergency and is treated with endovascular procedures. We aimed to analyze and report the early and midterm outcomes of surgeon-modified fenestrated stent-grafts (SMFSG) compared with other conventional endovascular methods in patients with BTAI repaired with zone 2 endovascular surgery. MATERIALS AND METHODS: Before and after the study was performed, from January 2015 to January 2020 for a period in which conventional endovascular treatments were used and from January 2020 to January 2023 for the second period in which the SMFSG technique was used...
September 20, 2023: Journal of Endovascular Therapy
https://read.qxmd.com/read/37704920/ct-angiography-of-non-aortic-thoracic-arterial-trauma
#15
REVIEW
Sudheer Balakrishnan
While aortic injury is the most commonly cited thoracic arterial injury, non-aortic arterial injuries represent an uncommon but significant source of morbidity and mortality in blunt and penetrating thoracic trauma patients. Knowledge of the spectrum of vascular injury and anatomic considerations that dictate patterns of associated thoracic hemorrhage will assist the radiologist in the accurate and efficient diagnosis of these injuries. This article provides a review of anatomy, pertinent clinical exam and CT angiography findings, as well as therapeutic options for non-aortic thoracic arterial trauma...
October 2023: Emergency Radiology
https://read.qxmd.com/read/37604750/exploring-the-role-of-endovascular-interventions-in-blunt-carotid-and-vertebral-artery-trauma
#16
JOURNAL ARTICLE
Walter L Biffl, Matthew Castelo, Imad S Dandan, Ning Lu, Patricia Rivera, Dunya Bayat
BACKGROUND: The role of endovascular interventions (EI) for blunt carotid and vertebral artery injuries (BCI and BVI) is poorly defined. The purpose of this study was to assess the efficacy of EI compared with antithrombotic therapy (AT) to inform future prospective study. METHODS: Retrospective review (2017-2022) of records at a Level I trauma center to determine injury, treatment, and outcome information. Primary outcome was stroke. RESULTS: 96 patients suffered 106 injuries (74 BVI, 32 BCI)...
July 24, 2023: American Journal of Surgery
https://read.qxmd.com/read/37599191/a-retrospective-analysis-of-the-clinical-use-and-utility-of-advanced-imaging-in-the-evaluation-of-near-hanging-and-strangulation-injuries-at-a-canadian-level-one-trauma-centre
#17
JOURNAL ARTICLE
Brent Hopkins, Anna Wang, Katherine McKendy, Dan Deckelbaum, Paola Fata, Kozar Khwaja, Atif Jastaniah, Tarek Razek, Evan Wong, Gregory Clark, Jeremy Richard Grushka
INTRODUCTION: Computed tomography (CT) of the neck is highly sensitive and may effectively rule-out cervical spine, cerebrovascular, and aerodigestive injuries after blunt and penetrating trauma. However, CT may be overutilized in the evaluation of hanging or strangulation injuries. The objective of this study was to determine the diagnostic yield of CT imaging among patients evaluated for hanging or strangulation mechanisms at a Canadian level-1 trauma center. METHODS: All adult patients evaluated for hanging or strangulation injuries over an eight-year period were reviewed...
October 2023: Injury
https://read.qxmd.com/read/37548568/traumatic-vertebral-artery-injury-denver-grade-bilaterality-and-stroke-risk-a-systematic-review-and-meta-analysis
#18
REVIEW
Giorgos D Michalopoulos, Zach Pennington, Peter Bambakidis, A Yohan Alexander, Nikita Lakomkin, Charalampos Charalampous, Sally El Sammak, Leslie C Hassett, Stephen Graepel, Fredric B Meyer, Mohamad Bydon
OBJECTIVE: Vertebral artery injury (VAI), a complication of blunt trauma, may cause posterior circulation stroke. An association of disease severity, classified in Denver grades, with stroke risk has not been shown. Using a literature-based analysis, the authors estimated the incidence of VAI following blunt trauma with the aim to investigate the impact of Denver grade and bilateral VAI on stroke occurrence. METHODS: A systematic review of the literature on VAI following blunt trauma was conducted, and data on its incidence, the severity per Denver grade, and stroke occurrence were collected...
July 28, 2023: Journal of Neurosurgery
https://read.qxmd.com/read/37515346/delayed-internal-carotid-artery-occlusion-and-paralysis-after-oral-trauma
#19
JOURNAL ARTICLE
Kento Kawakami, Yoshitaka Oyama, Yoshihiro Watanabe, Hirotaka Motoi, Mao Odaka, Kentaro Shiga, Shuichi Ito
No abstract text is available yet for this article.
2023: Pediatrics International: Official Journal of the Japan Pediatric Society
https://read.qxmd.com/read/37499267/endovascular-stenting-techniques-for-blunt-carotid-injury
#20
JOURNAL ARTICLE
Hossam Abdou, Rebecca N Treffalls, David P Stonko, Rishi Kundi, Jonathan J Morrison
OBJECTIVES: While methods of endovascular carotid artery stenting have improved over time, concerns surrounding the safety and efficacy of stenting for blunt carotid injury (BCI) remain. This study aims to present our approach to carotid artery stenting (CAS) by incorporating new technologies such as flow-diverting stents and circuits. METHODS: There is no robust evidence to support routine carotid artery stenting; however, there are several therapeutic options and approaches for treating BCI that currently require an individualized approach...
July 27, 2023: Vascular
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