title: Incidence of blunt craniocervical artery injuries: use of whole-body computed tomography trauma imaging with adapted computed tomography angiography.
abstract: BACKGROUND
  The incidence of traumatic craniocervical artery dissection varies in published trauma series.
  
  
  OBJECTIVE
  To determine the frequency of traumatic craniocervical artery injury in polytrauma patients by using standardized whole-body trauma computed tomography with adapted computed tomography angiography of the craniocervical vessels.
  
  
  METHODS
  A total of 718 consecutive patients requiring whole-body trauma computed tomography (16-row multislice) because of the mechanism of their injury patterns and an Injury Severity Scale score greater than 16 were analyzed prospectively. After a cranial scan, computed tomography angiography of the craniocervical vessels with 40 mL of iodinated contrast agent was performed using bolus tracking.
  
  
  RESULTS
  The overall incidence of blunt carotid and vertebral injuries (BCVIs) in the screened population was 1.7%. BCVIs were observed in 27.3% of patients with detected isolated cervical spine injuries and in 3.9% of patients with isolated cranial fractures with or without intracranial hemorrhage, whereas 5.3% of patients with combined cervical and cranial lesions were associated with BCVIs. In addition, 0.4% of BCVIs occurred in patients without evidence of head or neck trauma.
  
  
  CONCLUSIONS
  Whole-body trauma computed tomography with an adapted scanning protocol for the craniocervical vessels is a fast, safe, and feasible method for detecting vascular injuries. It allows prompt further treatment if necessary. Computed tomography angiography could be a part of a broad screening protocol for craniocervical vessels in documented injuries of the head and neck and in trauma mechanisms influencing the craniocervical region as well.
authors.affiliation: Department of Neurosurgery, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany. sfleck@uni-greifswald.de
authors.forename: Steffen K
authors.initials: SK
authors.lastname: Fleck
authors.forename: Soenke
authors.initials: S
authors.lastname: Langner
authors.forename: Joerg
authors.initials: J
authors.lastname: Baldauf
authors.forename: Michael
authors.initials: M
authors.lastname: Kirsch
authors.forename: Thomas
authors.initials: T
authors.lastname: Kohlmann
authors.forename: Henry W S
authors.initials: HW
authors.lastname: Schroeder
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D020196:Trauma, Nervous System / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D018616:Ultrasonography, Doppler, Duplex; D051598:Whole Body Imaging; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D055815:Young Adult