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Traumatic intracranial and extracranial vascular injuries in children

Roukoz B Chamoun1, Andrew Jea

  • 1Division of Pediatric Neurosurgery, Department of Neurosurgery, Texas Children's Hospital, Baylor College of Medicine, CCC 1230.01, 12th Floor, Houston, TX 77030, USA.

Neurosurgery Clinics of North America
|June 22, 2010
PubMed

Insights

Pediatric vascular trauma, especially in the head and neck, is a significant cause of death. Current diagnosis relies on angiography, with CT and MR angiography as emerging alternatives.

Area of Science:

  • Pediatric Traumatology
  • Vascular Surgery
  • Diagnostic Imaging

Background:

  • Trauma is a leading cause of death in children.
  • Vascular injuries, though uncommon, significantly contribute to pediatric trauma mortality and morbidity.
  • Head and neck vascular injuries represent a substantial portion of pediatric cases and are associated with high mortality.

Purpose of the Study:

  • To review current diagnostic and management trends for pediatric traumatic vascular injuries.
  • To highlight the challenges and evolving landscape of diagnosing these injuries.
  • To discuss the implications of vascular injuries on prognosis and current individualized treatment approaches.

Main Methods:

  • Literature review of available studies on pediatric traumatic vascular injuries.
  • Analysis of diagnostic modalities including catheter angiography, CT angiography, and MR angiography.
  • Examination of management strategies for both extracranial and intracranial vascular injuries.

Main Results:

  • Head and neck vascular injuries account for 19.4% of all pediatric vascular injuries and are linked to most observed mortality.
  • Catheter angiography remains the gold standard, but CT angiography and MR angiography are increasingly used screening tools.
  • Pediatric traumatic vascular injuries are diverse, affecting carotid and vertebral arteries, with unclear optimal management.

Conclusions:

  • Traumatic vascular injuries in children, particularly in the head and neck, require careful diagnosis and management.
  • The heterogeneity of these injuries necessitates individualized treatment plans.
  • Further research is needed to establish optimal management guidelines for pediatric traumatic vascular injuries.

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