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Published on: January 20, 2023
Traumatic Brain Injury Identifies a High-Risk Phenotype in Blunt Cerebrovascular Injury
Dagmawi Demessie1, Elge Stevens1, Linzi Paul1
1Louisiana State University Health Sciences Center, New Orleans, LA, USA.
The American Surgeon
|July 24, 2026
Summary
Concomitant traumatic brain injury (TBI) significantly increases mortality risk in patients with blunt cerebrovascular injury (BCVI). This high-risk subgroup requires closer monitoring and tailored management strategies for improved outcomes.
Area of Science:
- Trauma Surgery
- Neurosurgery
- Vascular Surgery
Background:
- Blunt cerebrovascular injury (BCVI) is associated with high morbidity and mortality.
- The impact of concurrent traumatic brain injury (TBI) on BCVI patient survival remains unclear.
Purpose of the Study:
- To investigate the mortality risk associated with TBI in patients diagnosed with BCVI.
Main Methods:
- A multicenter database analysis of adult BCVI patients diagnosed via CT angiography.
- Traumatic brain injury was defined by acute intracranial injury on head CT.
- Injury severity was graded using the Biffl classification.
Main Results:
- Of 1,674 BCVI patients, 44% had concomitant TBI.
- TBI patients were younger, had higher injury severity scores, and experienced more strokes.
- In-hospital mortality was significantly higher in BCVI patients with TBI (24.1% vs 6.4%).
- TBI (OR 1.63) and stroke (OR 1.82) were independent predictors of increased mortality.
Conclusions:
- Concomitant TBI identifies a high-risk subgroup of BCVI patients with greater injury severity.
- TBI is independently associated with increased in-hospital mortality in BCVI patients.
- Multidisciplinary evaluation and tailored management are recommended for BCVI patients with TBI.
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