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Pediatric Versus Adult Blunt Cerebrovascular Injuries: Patients Characteristics, Management, and Outcomes
Sina Asaadi1, Martin G Rosenthal1, Andrei Radulescu2
1Division of Acute Care Surgery, Department of Surgery, Loma Linda University, Loma Linda, CA.
Annals of Vascular Surgery
|March 13, 2025
Summary
Pediatric blunt cerebrovascular injury (BCVI) management mirrors adult approaches, showing comparable outcomes. Further research is needed for age-specific pediatric BCVI guidelines.
Area of Science:
- Vascular Surgery
- Pediatric Traumatology
- Emergency Medicine
Background:
- Current management of blunt cerebrovascular injury (BCVI) in children relies on adult guidelines, with limited pediatric-specific efficacy data.
- This study investigates pediatric BCVI features and compares them to adult cases.
Purpose of the Study:
- To explore injury characteristics in pediatric BCVI patients.
- To compare clinical manifestations, diagnosis, and treatment of pediatric versus adult BCVIs.
Main Methods:
- Retrospective analysis of the PROspective Observational Vascular Injury Treatment (PROOVIT) registry (2013-2022).
- Comparison of clinical data, treatment, and outcomes between pediatric (<18 years) and adult BCVI patients.
Main Results:
- Pediatric patients exhibited higher head Abbreviated Injury Scale scores and lower Glasgow Coma Scale scores on admission.
- Carotid artery injuries were most common in children, while vertebral artery injuries predominated in adults.
- BCVI-related stroke incidence and in-hospital mortality were similar between pediatric and adult groups, though pediatric patients had shorter hospital stays.
Conclusions:
- Pediatric BCVI management patterns are similar to adults, likely due to adapting adult-based care strategies.
- Outcomes in pediatric BCVI patients are comparable to adults, suggesting adapted approaches may be effective.
- There is a need for further research to develop age-specific guidelines for pediatric BCVI management.
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