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Performing Permanent Distal Middle Cerebral with Common Carotid Artery Occlusion in Aged Rats to Study Cortical Ischemia with Sustained Disability
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Grade 1 Internal Carotid Artery Blunt Cerebrovascular Injury Persistence Risks Stroke With Current Management: An

Sarah Yang1, Emily Esposito1, Chance Spalding2

  • 1R Adams Cowley Shock Trauma Center at University of Maryland School of Medicine, Baltimore, MD, USA.

The American Surgeon
|June 2, 2022
PubMed

Insights

For blunt cerebrovascular injury (BCVI) of the internal carotid artery (ICA), persistent injury on repeat imaging increases stroke risk. Some strokes occurred even after medical therapy initiation.

Area of Science:

  • Vascular Surgery
  • Neurology
  • Trauma Surgery

Background:

  • Higher blunt cerebrovascular injury (BCVI) grades and lack of medical therapy are linked to stroke.
  • Understanding stroke risk factors for specific BCVI grades can personalize treatment.

Purpose of the Study:

  • To analyze stroke risk in grade 1 internal carotid artery (ICA) BCVI.
  • To identify factors associated with stroke in grade 1 ICA BCVI patients.

Main Methods:

  • Post-hoc analysis of a prospective, observational trial (2018-2020) involving 16 centers.
  • Included patients with grade 1 ICA BCVI; repeat imaging defined as the second imaging occurrence.

Main Results:

  • Of 145 grade 1 ICA BCVI patients, 5.5% experienced stroke.
  • Stroke occurred more with mixed anticoagulation/antiplatelet therapy (75.0%) versus antiplatelet alone (25.0%).
  • Injuries without resolution on repeat imaging had a higher stroke rate (15.9%) compared to resolved injuries (0%).

Conclusions:

  • The overall stroke rate for grade 1 ICA BCVI is low, but injury persistence elevates risk.
  • Some strokes occurred despite medical therapy, highlighting the need for careful monitoring.
  • Repeat imaging is crucial for assessing injury progression or resolution in grade 1 ICA BCVI.
Abstract

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