Incidence of traumatic carotid and vertebral artery dissections: results of cervical vessel computed tomography angiogram as a mandatory scan component in severely injured patients
Incidence of traumatic carotid and vertebral artery dissections: results of cervical vessel computed tomography angiogram as a mandatory scan component in severely injured patients
Blog Article
Andreas Schicho,1 Lukas Luerken,1 Ramona Meier,1 Antonio Ernstberger,2 Christian Stroszczynski,1 Andreas Schreyer,1 Lena-Marie Dendl,1 Stephan Schleder1 1Department of Radiology, 2Department of Trauma Surgery, University Medical Center, Regensburg, Germany Purpose: The aim of this study was to evaluate the true incidence Towels of cervical artery dissections (CeADs) in trauma patients with an Injury Severity Score (ISS) of ≥16, since head-and-neck computed tomography angiogram (CTA) is not a compulsory component of whole-body trauma computed tomography (CT) protocols.Patients and methods: A total of 230 consecutive trauma patients with an ISS of ≥16 admitted to our Level I trauma center during a 24-month period were prospectively included.Standardized whole-body CT in a 256-detector row scanner included a head-and-neck CTA.Incidence, mortality, patient and trauma characteristics, and concomitant Pouf injuries were recorded and analyzed retrospectively in patients with carotid artery dissection (CAD) and vertebral artery dissection (VAD).
Results: Of the 230 patients included, 6.5% had a CeAD, 5.2% had a CAD, and 1.7% had a VAD.
One patient had both CAD and VAD.For both, CAD and VAD, mortality is 25%.One death was caused by fatal cerebral ischemia due to high-grade CAD.A total of 41.
6% of the patients with traumatic CAD and 25% of the patients with VAD had neurological sequelae.Conclusion: Mandatory head-and-neck CTA yields higher CeAD incidence than reported before.We highly recommend the compulsory inclusion of a head-and-neck CTA to whole-body CT routines for severely injured patients.Keywords: polytrauma, carotid artery, vertebral artery, dissection, blunt trauma, computed tomography angiogram.