Long-term outcome following blunt cerebrovascular injuries: occurrence of ischemic complications, treatment, and outcome

• DOI: 10.1007/s00068-021-01860-4
• Publication Date: 2022-01-22T00:04:11Z
• Authors: Camille Hego; Guillaume Rousseau; Paer-Selim Abback; Romain Pommier; Sophie-Rym Hamada; Benjamin Bergis; Igor Jurcisin; Alhassane Diallo; Catherine Paugam-...; Stéphanie Sigaut; Tobias Gauss; Jean-Denis Moyer
• Keywords: Decompressive craniectomy; Stroke; Sports medicine

Blunt cerebrovascular injuries (BCVI) are a rare but serious complication after trauma. Among patients with BCVI, neurological status is altered in 30% of cases and the prognosis seems to be associated with ischemic complications. The aim of this study was to assess the long-term outcome of BCVI-associated ischemic events.This retrospective cohort study (2011-2017) included all patients admitted for severe trauma with identified BCVI in two level-1 trauma centers. Patients were considered to have a poor neurological outcome with a GOS-E between 2 and 5 and a good neurological outcome with GOS-E between 6 and 8. A multivariate logistic regression identified risk factors for poor neurological outcome at 1 year.Of the 6,294 patients admitted in both trauma centers between 2011 and 2017, 81 patients presenting BCVI were identified (incidence of 1.3%). The median age was 35 years (24-44) with a median Injury Severity Score of 28 (17-41). 29 patients (50%) had a good neurological prognosis, while 25 patients (43%) had a poor neurological prognosis at 1 year. Ischemic stroke occurred in 11 patients (13.6%) within a median time of 2 days (2-2.5). No ischemic stroke occurred in the first year after ICU discharge in both groups. In our study, good prognosis at 1 year was not associated with ischemic complications [3 (10) vs 3 (12) p = 1].Ischemic complications after BCVI are rare, occur within the first week and do not seem to impact independently the 1-year neurological prognosis.