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Management of Blunt Cerebrovascular Injury

David K Stone1, Vyas T Viswanathan1, Christina A Wilson2

  • 1Department of Neurology, University of Florida, 1149 Newell Dr., PO Box 100236, Gainesville, FL, 32610, USA.

Current Neurology and Neuroscience Reports
|October 25, 2018
PubMed

Insights

Early diagnosis and treatment of blunt cerebrovascular injury (BCVI) are crucial for preventing stroke. Prompt screening and antithrombotic therapy significantly reduce stroke risk in affected patients.

Area of Science:

  • Neurology
  • Vascular Surgery
  • Trauma Care

Background:

  • Blunt cerebrovascular injury (BCVI) is a significant risk factor for stroke, with 10-40% of untreated patients experiencing this complication.
  • A majority of patients with BCVI do not initially present with stroke symptoms, making early detection critical.
  • The risk of stroke is highest within the first 7 days of injury, peaking within the first 24 hours.

Purpose of the Study:

  • To provide an updated summary of BCVI diagnosis, prevention, and treatment strategies.
  • To guide clinicians in the early identification and management of BCVI to prevent associated stroke.
  • To highlight the importance of timely intervention in reducing stroke incidence.

Main Methods:

  • Review of current literature and clinical guidelines on BCVI.
  • Emphasis on computed tomography (CT) angiography as the primary screening tool.
  • Discussion of diagnostic criteria and grading of BCVI severity.

Main Results:

  • Computed tomography (CT) angiography is the preferred screening method for BCVI.
  • Antithrombotic therapy is the primary treatment, demonstrating safety and efficacy in trauma patients.
  • Endovascular intervention may be considered for carefully selected patients.
  • Early screening and treatment are essential for stroke prevention in BCVI.

Conclusions:

  • A high index of suspicion and emergent screening are vital for identifying BCVI.
  • Screening should be considered for all patients with injuries warranting neck or chest CT scans.
  • Treatment decisions are guided by the injury grade, with early antithrombotic therapy being effective and safe.
Abstract

Keywords:
Blunt cerebrovascular traumaCarotid arteryCerebrovascular injuryDissectionStrokeVertebral artery

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