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Predictors for Pediatric Blunt Cerebrovascular Injury (BCVI): An International Multicenter Analysis

Christian D Weber1, Rolf Lefering2, Matthias S Weber3

  • 1Department of Orthopedics and Trauma Surgery, RWTH Aachen University Medical Center, Pauwels Street 30, 52074, Aachen, Germany. chrweber@ukaachen.de.

World Journal of Surgery
|June 5, 2019
PubMed

Insights

Blunt cerebrovascular injuries (BCVI) are rare in children but significantly increase mortality risk. Early recognition and management in high-risk pediatric trauma patients are crucial for better outcomes.

Area of Science:

  • Trauma Surgery
  • Pediatric Traumatology
  • Vascular Surgery

Background:

  • Blunt cerebrovascular injury (BCVI) guidelines exist for adults, but pediatric data are limited.
  • BCVI is a severe injury pattern with potentially devastating consequences in children.
  • Understanding pediatric BCVI is essential for improving patient outcomes.

Purpose of the Study:

  • To characterize BCVI in the pediatric population.
  • To analyze the prevalence, injury patterns, and outcomes of pediatric BCVI.
  • To identify risk factors and predictors for BCVI in children.

Main Methods:

  • International multicenter analysis of the TraumaRegister DGU® database (2002-2015).
  • Inclusion of pediatric trauma patients (0-17 years) with Injury Severity Score (ISS) ≥ 9.
  • Categorization of BCVI into carotid artery and vertebral artery injuries (VAI).

Main Results:

  • 48 BCVIs identified in 42 children (0.5% prevalence) among 8128 pediatric trauma patients.
  • Carotid injuries (0.4%) were more frequent than VAIs (0.1%).
  • BCVI patients had higher rates of associated head, facial, chest, and spinal injuries, increased thromboembolic complications (8.3%), and excessive in-hospital mortality (38.1%).

Conclusions:

  • BCVI is less common in pediatric than adult trauma patients but carries significant risks.
  • Special attention to BCVI and its complications is warranted in the early management of severe pediatric trauma.
  • High-risk children with severe trauma require vigilant screening for BCVI.
Abstract

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