Blunt cerebrovascular injury: an evaluation from a major trauma centre.
BACKGROUND
Blunt cerebrovascular injury (BCVI), although uncommon, is associated with substantial morbidity and mortality and remains poorly understood. This study was conducted to determine the pattern and outcome of BCVI at a major trauma centre.


METHODS
A retrospective review of all trauma admissions between 1996 and 2004 at Liverpool Hospital, the major trauma service for south-west Sydney, was undertaken using the hospital's computerized trauma registry.


RESULTS
Fourteen of the 7788 (0.18%) admitted blunt trauma patients sustained BCVI. Blunt carotid injury occurred in 10 of 14 and blunt vertebral injury occurred in 4 of 14 patients. Road trauma accounted for 9 of 14 cases. The median time to diagnosis was 2 days (range 1-45 days). The stroke rate was 36%, and the overall mortality was 29%.


CONCLUSIONS
This study identified BCVI as a relatively infrequent occurrence but with significant mortality and morbidity rates. Practice guidelines for both the screening and management of this patient group need to be developed and introduced in this major trauma centre.
Risgaard
Ole
O
Trauma Department, Liverpool Hospital, Liverpool, Australia. ori@dadlnet.dk
Sugrue
Michael
M
D'Amours
Scott
S
Christey
Grant
G
Smith
Katherine
K
Caldwell
Erica
E
Larivière
Christian
C
D001315:Australia / Q000453:epidemiology; D002339:Carotid Arteries; D020212:Carotid Artery Injuries / Q000453:epidemiology; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D014193:Trauma Centers; D014711:Vertebral Artery / Q000293:injuries; D014949:Wounds, Nonpenetrating / Q000453:epidemiology* / Q000401:mortality