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blunt cerebrovascular injuries

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https://www.readbyqxmd.com/read/28302280/blunt-cerebrovascular-injury-in-children
#1
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
#2
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
https://www.readbyqxmd.com/read/28246625/endovascular-management-of-a-combined-subclavian-and-vertebral-artery-injury-in-an-unstable-polytrauma-patient-case-report-and-literature-review
#3
Christian David Weber, Philipp Kobbe, Christian Herren, Andreas H Mahnken, Frank Hildebrand, Hans-Christoph Pape
While blunt trauma of the head and neck are a common pattern of injury, significant problems related to the prompt diagnosis and optimal management of traumatic artery injuries have been reported in the literature. While patients with major artery injuries might develop hemorrhagic shock very rapidly, patients with blunt cerebrovascular injuries (BCVI) can present asymptomatic, but complications like basilar territory infarction, cortical blindness and death may occur. We report the life- and limb-saving management in a 57-year-old hemodynamically unstable trauma patient...
January 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28156252/letter-to-the-editor-blunt-cerebrovascular-injuries-in-severe-tbi
#4
Xiao Wu, Ajay Malhotra
No abstract text is available yet for this article.
February 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28111193/impact-of-continuous-evaluation-of-technology-and-therapy-30-years-of-research-reduces-stoke-and-mortality-from-blunt-cerebrovascular-injury
#5
Charles P Shahan, Martin A Croce, Timothy C Fabian, Louis J Magnotti
BACKGROUND: Blunt cerebrovascular injury (BCVI) was underdiagnosed until the 1990s when blunt carotid injuries were found to be more common than historically described. Technological advancements and regionalization of trauma care have resulted in increased screening and improved diagnosis of BCVI. The aim of this study was to demonstrate that systematic evaluation of the screening and diagnosis of BCVI, combined with early and aggressive treatment, have led to reductions in BCVI-related stroke and mortality...
January 19, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28011882/mycophenolate-mofetil-prevents-cerebrovascular-injury-in-stroke-prone-spontaneously-hypertensive-rats
#6
Isha Dhande, Yaming Zhu, Michael C Braun, M John Hicks, Scott E Wenderfer, Peter A Doris
BACKGROUND AND PURPOSE: Stroke-prone spontaneously hypertensive rats (SHR-A3) develop strokes and progressive kidney disease as a result of naturally occurring genetic variations. We recently identified genetic variants in immune signaling pathways that contribute to end-organ injury. The present study was designed to test the hypothesis that a dysregulated immune response promotes stroke susceptibility. METHODS: 20-week old male SHR-A3 rats were salt loaded and treated with the immunosuppressant mycophenolate mofetil (MMF, 25 mg/kg/day, p...
December 23, 2016: Physiological Genomics
https://www.readbyqxmd.com/read/27979639/the-use-of-high-risk-criteria-in-screening-patients-for-blunt-cerebrovascular-injury-a-survey
#7
Xiao Wu, Ajay Malhotra, Howard P Forman, Diego Nunez, Pina Sanelli
RATIONALE AND OBJECTIVES: Blunt cerebrovascular injury (BCVI) is uncommon, but delayed detection can have disastrous consequences. The Denver criteria are the most commonly used screening criteria. We aim to examine the utilization of screening criteria in the emergency department (ED) of our institution and assess whether patients with risk factors were imaged. MATERIALS AND METHODS: A survey questionnaire was sent out to radiologists in a large academic institution...
December 12, 2016: Academic Radiology
https://www.readbyqxmd.com/read/27834598/letter-to-the-editor-screening-protocol-for-blunt-cerebrovascular-injury
#8
Xiao Wu, David Durand, Vivek B Kalra, Renu Liu, Ajay Malhotra
No abstract text is available yet for this article.
November 11, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27815845/the-craniocervical-junction-embryology-anatomy-biomechanics-and-imaging-in-blunt-trauma
#9
REVIEW
Curtis Edward Offiah, Emily Day
Imaging of the blunt traumatic injuries to the craniocervical junction can be challenging but central to improving morbidity and mortality related to such injury. The radiologist has a significant part to play in the appropriate management of patients who have suffered injury to this vital junction between the cranium and the spine. Knowledge of the embryology and normal anatomy as well as normal variant appearances avoids inappropriate investigations in these trauma patients. Osseous injury can be subtle while representing important radiological red flags for significant underlying ligamentous injury...
February 2017: Insights Into Imaging
https://www.readbyqxmd.com/read/27805989/screening-for-pediatric-blunt-cerebrovascular-injury
#10
Xiao Wu, Ajay Malhotra
No abstract text is available yet for this article.
January 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27781188/blunt-cerebrovascular-injury-in-cervical-spine-fractures-are-more-liberal-screening-criteria-warranted
#11
Gregory Grabowski, Ryan N Robertson, Blair M Barton, Mark A Cairns, Sharon W Webb
Study Design Retrospective comparative study. Objective To compare strict Biffl criteria to more-liberal criteria for computed tomography angiography (CTA) when screening for blunt cerebrovascular injury (BCVI). Methods All CTAs performed for blunt injury between 2009 and 2011 at our institution were reviewed. All patients with cervical spine fractures who were evaluated with CTA were included; patients with penetrating trauma and atraumatic reasons for imaging were excluded. We then categorized the patients' fractures based on the indications for CTA as either within or outside Biffl criteria...
November 2016: Global Spine Journal
https://www.readbyqxmd.com/read/27779588/re-screening-for-pediatric-blunt-cerebrovascular-injury
#12
C Patrick Shahan, Louis J Magnotti, Timothy C Fabian
No abstract text is available yet for this article.
January 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27767400/reliability-assessment-of-the-biffl-scale-for-blunt-traumatic-cerebrovascular-injury-as-detected-on-computer-tomography-angiography
#13
Paul M Foreman, Christoph J Griessenauer, Kimberly P Kicielinski, Philip G R Schmalz, Brandon G Rocque, Matthew R Fusco, Joseph C Sullivan, John P Deveikis, Mark R Harrigan
OBJECTIVE Blunt traumatic cerebrovascular injury (TCVI) represents structural injury to a vessel due to high-energy trauma. The Biffl Scale is a widely accepted grading scheme for these injuries that was developed using digital subtraction angiography. In recent years, screening CT angiography (CTA) has been used to identify patients with TCVI. The reliability of this scale, with injuries assessed using CTA, has not yet been determined. METHODS Seven independent raters, including 2 neurosurgeons, 2 neuroradiologists, 2 neurosurgical residents, and 1 neurosurgical vascular fellow, independently reviewed each presenting CTA of the neck performed in 40 patients with confirmed TCVI and assigned a Biffl grade...
October 21, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27751528/expanded-screening-criteria-for-blunt-cerebrovascular-injury-a-bigger-impact-than-anticipated
#14
Andrea E Geddes, Clay Cothren Burlew, Amy E Wagenaar, Walter L Biffl, Jeffrey L Johnson, Fredric M Pieracci, Eric M Campion, Ernest E Moore
BACKGROUND: We implemented expanded screening criteria for blunt cerebrovascular injuries (BCVIs) in an attempt to capture the remaining 20% of patients not historically identified with earlier protocols. We hypothesized that these expanded criteria would capture the additional 20% of BCVI patients not previously identified. METHODS: Screening criteria for BCVI were expanded in 2011 after identifying new injury patterns. The study population included 4 years prior (2007 to 2010; classic) and following (2011 to 2014; expanded) implementation of expanded criteria...
December 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27648396/surgical-and-nonsurgical-treatment-of-vascular-skull-base-trauma
#15
REVIEW
Brian C Dahlin, Ben Waldau
Vascular trauma is associated with blunt skull base fractures and penetrating injuries. We review the contemporary management of cranial vascular trauma, including blunt and penetrating cerebrovascular injury as well as refractory epistaxis from facial trauma.
October 2016: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/27537517/long-term-follow-up-of-blunt-cerebrovascular-injuries-does-time-heal-all-wounds
#16
Adriana Laser, Brandon R Bruns, Joseph Kufera, Andrew Kim, Timothy Feeney, Ronald B Tesoriero, Margaret H Lauerman, Clint W Sliker, Thomas M Scalea, Deborah M Stein
BACKGROUND: The short-term natural history of blunt cerebrovascular injuries (BCVI) has been previously described in the literature, but the purpose of this study is to analyze long-term serial follow-up and lesion progression of BCVI. METHODS: This is a single institution's retrospective review of a prospectively collected database over four years (2009-2013). All patients diagnosed with BCVI by CT scan were identified and injuries graded based on modified Denver scale...
August 18, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27534950/neurosurgical-emergencies-in-sports-neurology
#17
REVIEW
Vin Shen Ban, James A Botros, Christopher J Madden, H Hunt Batjer
PURPOSE OF REVIEW: Athletic neurosurgical emergencies are injuries that can lead to mortality or significant morbidity and require immediate recognition and treatment. This review article discusses the epidemiology of sports-related traumatic brain injury (TBI) with an attempt to quantify the incidence of neurosurgical emergencies in sports. Emergencies such as intracranial hemorrhage, second impact syndrome, vascular injuries, and seizures are discussed. RECENT FINDINGS: The incidence of sports-related TBI presenting to level I or II trauma centers in the USA is about 10 in 100,000 population per year...
September 2016: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/27533909/unfractionated-heparin-after-tbi-reduces-in-vivo-cerebrovascular-inflammation-brain-edema-and-accelerates-cognitive-recovery
#18
Katsuhiro Nagata, Kenichiro Kumasaka, Kevin D Browne, Shengjie Li, Jesse St-Pierre, John Cognetti, Joshua Marks, Victoria E Johnson, Douglas H Smith, Jose L Pascual
BACKGROUND: Severe traumatic brain injury (TBI) may increase the risk of venous thromboembolic complications; however, early prevention with heparinoids is often withheld for its anticoagulant effect. New evidence suggests low molecular weight heparin reduces cerebral edema and improves neurological recovery after stroke and TBI, through blunting of cerebral leukocyte (LEU) recruitment. It remains unknown if unfractionated heparin (UFH) similarly affects brain inflammation and neurological recovery post-TBI...
December 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27471889/blunt-cerebrovascular-injuries-in-severe-traumatic-brain-injury-incidence-risk-factors-and-evolution
#19
Pierre Esnault, Mickaël Cardinale, Henry Boret, Erwan D'Aranda, Ambroise Montcriol, Julien Bordes, Bertrand Prunet, Christophe Joubert, Arnaud Dagain, Philippe Goutorbe, Eric Kaiser, Eric Meaudre
OBJECTIVE Blunt cerebrovascular injuries (BCVIs) affect approximately 1% of patients with blunt trauma. An antithrombotic or anticoagulation therapy is recommended to prevent the occurrence or recurrence of neurovascular events. This treatment has to be carefully considered after severe traumatic brain injury (TBI), due to the risk of intracranial hemorrhage expansion. Thus, the physician in charge of the patient is confronted with a hemorrhagic and ischemic risk. The main objective of this study was to determine the incidence of BCVI after severe TBI...
July 29, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27465848/treatment-practices-and-outcomes-after-blunt-cerebrovascular-injury-in-children
#20
Michael C Dewan, Vijay M Ravindra, Stephen Gannon, Colin T Prather, George L Yang, Lori C Jordan, David Limbrick, Andrew Jea, Jay Riva-Cambrin, Robert P Naftel
BACKGROUND: Pediatric blunt cerebrovascular injury (BCVI) lacks accepted treatment algorithms, and postinjury outcomes are ill defined. OBJECTIVE: To compare treatment practices among pediatric trauma centers and to describe outcomes for available treatment modalities. METHODS: Clinical and radiographic data were collected from a patient cohort with BCVI between 2003 and 2013 at 4 academic pediatric trauma centers. RESULTS: Among 645 pediatric patients evaluated with computed tomography angiography for BCVI, 57 vascular injuries (82% carotid artery, 18% vertebral artery) were diagnosed in 52 patients...
December 2016: Neurosurgery
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