The epidemiology of BCVI at a single state trauma centre.
BACKGROUND
Blunt carotid and vertebral artery injury (BCVI) is a relatively uncommon but potentially devastating injury. The aim of our study was to highlight the incidence, patterns, presentation and associations of BCVI at our institution.


METHODS
Retrospective data between 1st January 2003 and 31st December 2006 was obtained from The Alfred Hospital's health information system, patient medical records and the Department of Neurosurgery's database. Injuries were graded using the Denver grading scale.


RESULTS
67 patients (0.64%) out of 10,417 minor and major trauma admissions, were diagnosed with BCVI. 33 (49%) sustained blunt carotid and 34 (51%) sustained blunt vertebral injuries. Motor vehicle accident (MVA) was the cause in 43 out of 67. 35% had associated head injury whilst 57% had concurrent cervical spine fractures. Odds ratio analysis showed that MVA victims with concomitant upper cervical spine injury were 22.9 times more likely to suffer BCVI than those without such risk factors. Approximately 50% of patients had a Glasgow coma score of 14 or less (GCS < or = 14). Grade 4 BCVI was most common. Stroke occurred in 22 (32%) and mortality in 14 (20%).


CONCLUSIONS
BCVI although infrequent, is a serious injury. Our study suggests that MVA patients with cervical spine fractures especially of the upper C-spine are at much higher risk of BCVI than those without such injuries.
Hwang
Peter Y K
PY
Department of Neurosurgery, Alfred Hospital, Prahran, Victoria, Australia. p.hwang@alfred.org.au
Lewis
Philip M
PM
Balasubramani
Yagnesh V
YV
Madan
Anoop
A
Rosenfeld
Jeffrey V
JV
D000328:Adult; D001315:Australia / Q000453:epidemiology; D020212:Carotid Artery Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D002533:Cerebral Angiography; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014193:Trauma Centers; D016896:Treatment Outcome; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery