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blunt cerebrovascular injuries

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https://www.readbyqxmd.com/read/28799874/limitations-of-multidetector-computed-tomography-angiography-for-the-diagnosis-of-blunt-cerebrovascular-injury
#1
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
#2
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
#3
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
#4
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
#5
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...
June 30, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28658027/transcranial-doppler-microemboli-monitoring-for-stroke-risk-stratification-in-blunt-cerebrovascular-injury
#6
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...
June 24, 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
#7
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
#8
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...
May 5, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28399527/blunt-traumatic-extracranial-cerebrovascular-injury-and-ischemic-stroke
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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-stroke-and-mortality-from-blunt-cerebrovascular-injury
#15
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...
April 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
#16
Isha S Dhande, Yaming Zhu, Michael C Braun, M John Hicks, Scott E Wenderfer, Peter A Doris
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. We salt-loaded 20 wk old male SHR-A3 rats and treated them with the immunosuppressant mycophenolate mofetil (MMF, 25 mg/kg/day po) (n = 8) or vehicle (saline) (n = 9) for 8 wk...
March 1, 2017: Physiological Genomics
https://www.readbyqxmd.com/read/27979639/the-use-of-high-risk-criteria-in-screening-patients-for-blunt-cerebrovascular-injury-a-survey
#17
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
#18
Xiao Wu, David Durand, Vivek B Kalra, Renu Liu, Ajay Malhotra
No abstract text is available yet for this article.
April 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27815845/the-craniocervical-junction-embryology-anatomy-biomechanics-and-imaging-in-blunt-trauma
#19
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
#20
Xiao Wu, Ajay Malhotra
No abstract text is available yet for this article.
January 2017: Journal of Trauma and Acute Care Surgery
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