Article Figures & Data
Figures
- Fig 1.
Flow chart of the simplified model. VAI indicates vertebral artery injury; CAI, carotid artery injury.
- Fig 2.
Scatterplot of incremental cost (cost of selective DSA and cost of selective CTA) versus incremental effectiveness (effectiveness of selective DSA and effectiveness of selective CTA). The incremental effectiveness in all iterations was negative (selective DSA has worse outcomes), and the incremental costs were positive (selective DSA is more expensive), suggesting that selective DSA is less cost-effective than selective CTA.
Tables
Signs and symptoms Arterial hemorrhage/expanding cervical hematoma Cervical bruit Focal neurologic deficit Neurologic examination incongruous with head CT scan findings Stroke on secondary CT scan Risk factors Maxillo facial fractures–Le Fort II or III fracture Cervical spine fracture patterns: extension into the transverse foramen, C1–C3 vertebral fractures Skull base fracture extending to involve the carotid canal Diffuse axonal injury with GCS score <6 Near hanging with anoxic brain injury Note:—GCS indicates Glasgow Coma Scale. Table adapted from Cothren et al.34
Strategy Cost ($) Effectiveness (QALY) Selective anticoagulation 21.08 0.7231074 Selective CTA 48.84 0.7229382 Selective DSA 284.62 0.7228022 CTA for all 419.11 0.7229337 DSA for all 5594.16 0.7196092
Evaluation for Blunt Cerebrovascular Injury: Review of the Literature and a Cost-Effectiveness Analysis
