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Current Concepts in Imaging Diagnosis and Screening of Blunt Cerebrovascular Injuries

Tiffany Y So1, Apurva Sawhney1, Lei Wang1

  • 1Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China.

Tomography (Ann Arbor, Mich.)
|February 24, 2022
PubMed

Insights

Blunt cerebrovascular injury (BCVI) is an underrecognized condition affecting carotid and vertebral arteries, potentially leading to stroke. Early identification through computed tomographic angiography (CTA) and risk factor assessment is crucial for timely intervention.

Area of Science:

  • Vascular Surgery
  • Radiology
  • Trauma Medicine

Background:

  • Blunt cerebrovascular injury (BCVI) is frequently underdiagnosed.
  • BCVI involves injuries to the carotid or vertebral arteries.
  • It carries risks of ischemic stroke, poor neurological outcomes, and mortality.

Purpose of the Study:

  • To highlight the importance of recognizing BCVI.
  • To discuss imaging findings associated with BCVI.
  • To emphasize the role of clinical and radiological risk factors in identifying at-risk patients.

Main Methods:

  • Computed tomographic angiography (CTA) is the primary imaging modality.
  • Review of potential imaging findings including intimal injuries, thrombus, dissection, hematoma, pseudoaneurysm, transection, and arteriovenous fistula.
  • Assessment of clinical and radiological risk factors for patient selection.

Main Results:

  • CTA enables the diagnosis of various BCVI manifestations.
  • Specific imaging findings correlate with the severity and type of injury.
  • Identification of high-risk patients allows for targeted screening protocols.

Conclusions:

  • BCVI requires vigilant recognition in trauma patients.
  • CTA is essential for diagnosing BCVI and its associated pathologies.
  • Targeted screening based on risk factors improves detection rates for BCVI.

Keywords:
blunt cerebrovascular injurycarotid arteriesneck injuriesstrokevertebral arteries

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