Characterizing Blunt Cerebrovascular Injuries and Stroke: A Single Center Retrospective Study
Lillie Tien1, Dan-Victor Giurgiutiu2, Erin F Switzer3
1Medical College of Georgia at Augusta University.
Insights
Blunt cerebrovascular injuries can lead to ischemic stroke. Early neurologist consultation is crucial for preventing and managing strokes in trauma patients, potentially reducing patient risk.
Area of Science:
- Neurology
- Trauma Surgery
- Vascular Surgery
Background:
- Blunt cerebrovascular injuries (BCVI) are a significant concern in trauma patients.
- Ischemic stroke is a potential complication of BCVI, necessitating specialized management.
Purpose of the Study:
- To determine the incidence of ischemic stroke following BCVI.
- To evaluate the neurologist's role in the prevention and management of ischemic stroke in this patient cohort.
Main Methods:
- Retrospective chart review of patients with BCVI from 2016-2019 at a Level I trauma center.
- Analysis of demographics, injury mechanisms, stroke occurrence, interventions, and neurology consultations.
- Descriptive statistics to characterize stroke patterns and management.
Main Results:
- Nine out of forty patients (22.5%) with BCVI developed ischemic stroke.
- Carotid artery injuries were associated with a 33.3% stroke rate (6/18), and vertebral artery injuries with an 11.1% rate (3/27).
- Most strokes occurred by hospital day two, with neurology consultations typically occurring on hospital day four.
Conclusions:
- A substantial proportion of BCVI patients are at risk for ischemic stroke.
- Polytrauma can delay diagnosis and treatment, impacting stroke prevention.
- Earlier neurology consultation can potentially decrease the burden of ischemic stroke in trauma patients.
Objective:
To highlight the occurrence of ischemic stroke after blunt cerebrovascular injuries and discuss the neurologist's role in preventing and managing ischemic strokes in this trauma population.
Methods:
A retrospective chart review was performed and included data from 2016 to 2019 from a Level I trauma center. Demographics, injury mechanism, ischemic stroke occurrence, interventions, and neurology consultations were examined and descriptive statistics were utilized to characterize the nature of ischemic strokes and their management.
Results:
A total of forty patients (81% male, average age 44) presented with blunt cerebrovascular injury, nine of whom later developed ischemic stroke. Eighteen patients had a carotid artery injury with six developing ischemic stroke. Twenty-seven patients had a vertebral artery injury with three developing ischemic stroke. Six of the nine ischemic strokes occurred on hospital day two, whereas neurology was generally consulted on hospital day four.
Conclusions:
A considerable portion of patients may go on to develop ischemic stroke following blunt cerebrovascular injuries. Polytrauma may interfere with prompt diagnosis which may contribute to delayed anti-thrombotic therapy for ischemic stroke prevention. Neurologists have the opportunity to reduce ischemic stroke burden in this trauma population and patients may benefit from earlier neurology consultation.
