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blunt cerebrovascular injuries

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https://www.readbyqxmd.com/read/29137056/optic-nerve-injury-associated-blunt-cerebrovascular-injury-three-case-reports
#1
Dan-Dong Li, Liu-Xun Hu, Linyuan Sima, Shang-Yu Xu, Jian Lin, Nu Zhang, Bo Yin
RATIONALE: Blunt cerebrovascular injury (BCVI) is a rare complication that may occur after craniocervical trauma. The current literature is limited to extracranial carotid artery injuries; however, no reports have been published on blunt intracranial carotid injury (BICI), especially those associated with optic nerve injury. PATIENT CONCERNS: Here we report on 3 BICI cases that demonstrated optic nerve injuries after craniofacial injuries. All 3 patients showed post-trauma vision loss on the injured side...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29123850/delayed-massive-epistaxis-from-traumatic-intracranial-aneurysm-after-blunt-facial-injury
#2
Hajime Nakamura, Toshiyuki Fujinaka, Osamu Tasaki, Toshiki Yoshimine
Cases: Traumatic intracranial aneurysm following blunt head injury is uncommon but can be induced by extension of skull base fracture and causes unexpected hemorrhagic complications. We present two cases of traumatic intracranial aneurysm in the paraclinoid area that was revealed by delayed massive epistaxis. Lack of initial neurological deficits omitted screening for cerebrovascular injury. Outcome: Internal trapping was carried out using endovascular techniques in both cases, with extracranial-intracranial bypass in one case...
January 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29108846/predictors-of-pediatric-blunt-cerebrovascular-injury
#3
Avery C Rossidis, Sasha J Tharakan, Sourav K Bose, Karuna V Shekdar, Michael L Nance, Thane A Blinman
BACKGROUND/PURPOSE: Blunt cerebrovascular injury (BCVI) is clinically challenging because these injuries are hard to detect and can have serious neurological consequences, and optimal screening criteria have not been established for children. This study aims to determine risk factors for BCVI in pediatric patients and to evaluate screening practices in a single institutional series. METHODS: A retrospective review of all pediatric blunt trauma patients evaluated over a 10-year period was performed...
October 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29027732/blunt-cerebrovascular-injury-early-recognition-and-treatment-options-in-asymptomatic-patient
#4
Alexander Becker, Dror Ashkenazi, Dan Hershko
No abstract text is available yet for this article.
October 13, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29025722/blunt-cerebrovascular-injuries-advances-in-screening-imaging-and-management-trends
#5
REVIEW
P Nagpal, B A Policeni, G Bathla, A Khandelwal, C Derdeyn, D Skeete
Blunt cerebrovascular injury is a relatively uncommon but sometimes life-threatening injury, particularly in patients presenting with ischemic symptoms in that vascular territory. The decision to pursue vascular imaging (generally CT angiography) is based on clinical and imaging findings. Several grading scales or screening criteria have been developed to guide the decision to pursue vascular imaging, as well as to recommend different treatment options for various injuries. The data supporting many of these guidelines and options are limited however...
October 12, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28922275/indications-for-ct-angiography-of-the-vertebral-arteries-after-trauma
#6
Joseph P Drain, Douglas S Weinberg, James S Ramey, Timothy A Moore, Heather A Vallier
STUDY DESIGN: Retrospective. OBJECTIVE: The purpose of this project is to identify factors that predict vertebral artery injury (VAI) in an effort to assess risks and benefits of computed tomography angiography (CT-A) of the neck in the trauma setting. We seek to develop guidelines for practitioners to stratify patients at medium/high risk of VAI from those who are at low risk. SUMMARY OF BACKGROUND DATA: VAI and blunt carotid injury (BCI) together comprise blunt cerebrovascular injury (BCVI)...
September 15, 2017: Spine
https://www.readbyqxmd.com/read/28886695/cerebral-microvascular-dysfunction-in-metabolic-syndrome-is-exacerbated-by-ischemia-reperfusion-injury
#7
Nathalie Obadia, Marcos Adriano Lessa, Anissa Daliry, Raquel Rangel Silvares, Fabiana Gomes, Eduardo Tibiriçá, Vanessa Estato
BACKGROUND: Metabolic syndrome (MetS) is associated with an increased risk of cerebrovascular diseases, including cerebral ischemia. Microvascular dysfunction is an important feature underlying the pathophysiology of cerebrovascular diseases. In this study, we aimed to investigate the impacts of ischemia and reperfusion (IR) injury on the cerebral microvascular function of rats with high-fat diet-induced MetS. RESULTS: We examined Wistar rats fed a high-fat diet (HFD) or normal diet (CTL) for 20 weeks underwent 30 min of bilateral carotid artery occlusion followed by 1 h of reperfusion (IR) or sham surgery...
September 8, 2017: BMC Neuroscience
https://www.readbyqxmd.com/read/28877048/current-opinion-in-otolaryngology-update-on-vascular-injuries-in-craniomaxillofacial-fractures
#8
Elisa Illing, Sarah Jo Burgin, Cecelia E Schmalbach
PURPOSE OF REVIEW: The primary purpose of this chapter is to define current recommendations for vascular work-up of patients with craniomaxillofacial (CMF) trauma with emphasis on imaging to include intraoperative fluorescence, angiography, and surgical exploration. The second goal is to review current management recommendations for observation versus surgical exploration based on the neck zones of injury. RECENT FINDINGS: Over the past two decades, endovascular techniques are increasingly utilized, particularly in zones I and III of the neck...
December 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28799874/limitations-of-multidetector-computed-tomography-angiography-for-the-diagnosis-of-blunt-cerebrovascular-injury
#9
Ramesh Grandhi, Gregory M Weiner, Nitin Agarwal, David M Panczykowski, William J Ares, Jesse S Rodriguez, Jonathan A Gelfond, John G Myers, Louis H Alarcon, David O Okonkwo, Brian T Jankowitz
OBJECTIVE Blunt cerebrovascular injuries (BCVIs) following trauma carry risk for morbidity and mortality. Since patients with BCVI are often asymptomatic at presentation and neurological sequelae often occur within 72 hours, timely diagnosis is essential. Multidetector CT angiography (CTA) has been shown to be a noninvasive, cost-effective, reliable means of screening; however, the false-positive rate of CTA in diagnosing patients with BCVI represents a key drawback. Therefore, the authors assessed the role of DSA in the screening of BCVI when utilizing CTA as the initial screening modality...
August 11, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28789779/management-of-blunt-cerebrovascular-injury-bcvi-in-the-multisystem-injury-patient-with-contraindications-to-immediate-anti-thrombotic-therapy
#10
Michelle K McNutt, A Cozette Kale, Ryan S Kitagawa, Ali H Turkmani, David W Fields, Sarah Baraniuk, Brijesh S Gill, Bryan A Cotton, Laura J Moore, Charles E Wade, Arthur Day, John B Holcomb
INTRODUCTION: Practice management guidelines for screening and treatment of patients with blunt cerebrovascular injury (BCVI) have been associated with a decreased risk of ischemic stroke. TREATMENT: of patients with BCVI and multisystem injuries that delays immediate antithrombotic therapy remains controversial. The purpose of this study was to determine the timing of BCVI treatment initiation, the incidence of stroke, and bleeding complications as a result of antithrombotic therapy in patients with isolated BCVI in comparison to those with BCVI complicated by multisystem injuries...
July 31, 2017: Injury
https://www.readbyqxmd.com/read/28686115/letter-to-the-editor-biffl-scale-for-blunt-traumatic-cerebrovascular-injury
#11
Xiao Wu, Ajay Malhotra
No abstract text is available yet for this article.
July 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28686114/erratum-reliability-assessment-of-the-biffl-scale-for-blunt-traumatic-cerebrovascular-injury-as-detected-on-computer-tomography-angiography
#12
Paul M Foreman
No abstract text is available yet for this article.
July 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28674346/diagnosis-and-treatment-of-traumatic-cerebrovascular-injury-pitfalls-in-the-management-of-neurotrauma
#13
Hitoshi Kobata
Traumatic cerebrovascular injury (TCVI) is an uncommon clinical entity in traumatic brain injury (TBI), yet it may cause devastating brain injury with high morbidity and mortality. Early recognition and prioritized strategic treatment are of paramount importance. A total of 1966 TBI patients admitted between 1999 and 2015 in our tertiary critical care center were reviewed. Screening of TCVI was based on the Guidelines for the Management of Severe Head Injury in Japan. TCVI was confirmed in 33 (1.7%) patients; 29 blunt and 4 penetrating injuries...
August 15, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28658027/transcranial-doppler-microemboli-monitoring-for-stroke-risk-stratification-in-blunt-cerebrovascular-injury
#14
Robert H Bonow, Cordelie E Witt, Bryan P Mosher, Mahmud Mossa-Basha, Monica S Vavilala, Frederick P Rivara, Joseph Cuschieri, Saman Arbabi, Randall M Chesnut
OBJECTIVES: To assess whether microemboli burden, assessed noninvasively by bedside transcranial Doppler ultrasonography, correlates with risk of subsequent stroke greater than 24 hours after hospital arrival among patients with blunt cerebrovascular injury. The greater than 24-hour time frame provides a window for transcranial Doppler examinations and therapeutic interventions to prevent stroke. DESIGN: Retrospective cohort study. SETTING: Level I trauma center...
October 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28640778/a-cohort-study-of-blunt-cerebrovascular-injury-screening-in-children-are-they-just-little-adults
#15
Mackenzie R Cook, Cordelie E Witt, Robert H Bonow, Eileen M Bulger, Ken F Linnau, Saman Arbabi, Bryce R H Robinson, Joseph Cuschieri
BACKGROUND: Blunt cerebrovascular injuries (BCVI) are rare with nonspecific predictors, making optimal screening critical. Radiation concerns magnify these issues in children. The Eastern Association for the Surgery of Trauma (EAST) criteria, the Utah score (US) and the Denver criteria (DC) have been advocated for pediatric BCVI screening, though direct comparison is lacking. We hypothesized that current screening guidelines inaccurately identify pediatric BCVI. METHODS: This was a retrospective cohort study of pediatric trauma patients treated from 2005-2015 with radiographically confirmed BCVI...
June 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28475705/management-of-penetrating-cerebrovascular-injuries-in-pediatric-trauma-a-retrospective-multicenter-study
#16
Vijay M Ravindra, Michael C Dewan, Hassan Akbari, Robert J Bollo, David Limbrick, Andrew Jea, Robert P Naftel, Jay K Riva-Cambrin
BACKGROUND: Blunt cerebrovascular injury is uncommon in the pediatric population; penetrating cerebrovascular injuries are even rarer and are thus poorly understood. OBJECTIVE: To describe the diagnosis and management of penetrating cerebrovascular injuries and describe outcomes of available treatment modalities. METHODS: Clinical and radiographic data were collected retrospectively from a multicenter trauma registry for children screened for cerebrovascular injury during 2003 to 2013 at 4 academic pediatric trauma centers...
September 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28399527/blunt-traumatic-extracranial-cerebrovascular-injury-and-ischemic-stroke
#17
Paul M Foreman, Mark R Harrigan
BACKGROUND: Ischemic stroke occurs in a significant subset of patients with blunt traumatic cerebrovascular injury (TCVI). The patients are victims of motor vehicle crashes, assaults or other high-energy collisions, and suffer ischemic stroke due to injury to the extracranial carotid or vertebral arteries. SUMMARY: An increasing number of patients with TCVI are being identified, largely because of the expanding use of computed tomography angiography for screening patients with blunt trauma...
2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28383858/-blunt-cerebrovascular-injury
#18
P Bouchat, F Pitance, F Damas, L Trippaerts
A blunt cerebrovascular injury (BCVI) can cause severe cerebral ischemic sequelae. The diagnosis is tricky and often entails a latency period. Adequate treatment at this time will dramatically reduce mortality and morbidity. The Denver protocol guides the selection of the patients to be screened. Current treatment is based on heparin, anticoagulant antiplatelet drugs, interventional radiology and surgery. The treatment is based on a dynamic strategy.
June 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28302280/blunt-cerebrovascular-injury-in-children
#19
REVIEW
Stephen J Fenton, Robert J Bollo
Blunt cerebrovascular injury in children is an uncommon occurrence that if missed and left untreated can result in devastating long-term neurologic consequences. Diagnosis can be readily obtained by a computed tomographic angiogram of the head and neck. If confirmed, treatment with antithrombotic therapy dramatically reduces the risk of a cerebrovascular accident. The difficulty lies in determining which child should be screened for such an injury. Several institutions have come up with criteria for screening...
February 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28280639/delayed-stroke-following-blunt-neck-trauma-a-case-illustration-with-recommendations-for-diagnosis-and-treatment
#20
Best Anyama, Daniela Treitl, Jeffery Wessell, Rachele Solomon, Andrew A Rosenthal
Blunt cerebrovascular injury (BCVI) to the carotid artery is a relatively rare injury that is difficult to identify even with imaging. Any symptoms or neurological deficits following blunt neck injury mandate evaluation and consideration of BCVI. In an effort to highlight this issue, we report the case of a 31-year-old male patient who presented with left-sided weakness consistent with transient ischemic attack (TIA) and concussion. The patient's symptoms occurred within 24 hours of a blunt neck injury sustained by a knee strike during a basketball game...
2017: Case Reports in Emergency Medicine
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