Clinical utility of a screening protocol for blunt cerebrovascular injury using computed tomography angiography

• DOI: 10.3171/2016.1.jns151545
• Publication Date: 2016-04-22T14:00:49Z
• Authors: Michael K. Tso; Myunghyun M. Lee; Chad G. Ball; William F. Morrish; Alim P. Mitha; Andrew W. Kirkpat...; John H. Wong
• Keywords: Stroke; Computed Tomography Angiography; Trauma Center; Blunt trauma

OBJECTIVE Blunt cerebrovascular injury (BCVI) occurs in approximately 1% of the blunt trauma population and may lead to stroke death. Early vascular imaging asymptomatic patients at high risk having BCVI earlier diagnosis possible prevention. The objective this study was determine if implementation a formalized screening protocol with CT angiography (CTA) would improved detection METHODS Patients studies were identified from prospective registry single Level 1 center between 2002 2008. Detection rates compared during 3-year periods before after consensus-based using CTA 2005. RESULTS A total 5480 identified. overall rate remained unchanged postprotocol preprotocol (0.8% [24 3049 patients] vs 0.9% [23 2431 patients]; p = 0.53). However, there trend toward decreased secondary on basis (0.23% [7 0.53% [13 0.06). Overall, 75% (35 47) treated antiplatelet agents, but no patient developed new or progressive intracranial hemorrhage despite 70% these concomitant traumatic brain injury. CONCLUSIONS results suggest that for be clinical benefit reduction ischemic complications. treatment agents appears safe.