Blunt vascular neck injuries: diagnosis and outcomes of extracranial vessel injury

J Trauma. 2002 Sep;53(3):472-6. doi: 10.1097/00005373-200209000-00013.

Abstract

Background: Blunt vascular neck injuries (BVNIs) are rare, often occult, and potentially devastating injuries. The purpose of this study was to identify a high-risk group, which would benefit from screening.

Methods: Patients with BVNIs were identified from our trauma registry and charts were reviewed. Potential risk factors for BVNI were evaluated by univariate and multivariate logistic regression.

Results: Thirty-one BVNIs were identified in 22 patients. The stroke rate was 60% and the mortality rate was 25%. Univariate analysis showed Glasgow Coma Scale score < or = 8, head injury (Abbreviated Injury Scale [AIS] score > or = 3), basal skull fracture, facial injury, other neck injury, thorax injury (AIS score > or = 3), abdominal injury, and cervical spine injury to be significant (p < 0.05). The multivariate predictive model had two predictors remaining significant: thorax injury (AIS [thorax] score > or = 3) and Glasgow Coma Scale score < or = 8.

Conclusion: Screening should be undertaken for patients at increased risk for BVNI: those with risk factors identified in our regression analysis and factors previously reported.

MeSH terms

  • Adult
  • Brain / blood supply
  • British Columbia / epidemiology
  • Carotid Artery Injuries / diagnosis*
  • Carotid Artery Injuries / diagnostic imaging
  • Carotid Artery Injuries / epidemiology*
  • Carotid Artery Injuries / pathology
  • Case-Control Studies
  • Cerebral Angiography / statistics & numerical data
  • Decision Trees
  • Female
  • Glasgow Coma Scale
  • Hospitals, General / statistics & numerical data*
  • Humans
  • Injury Severity Score
  • Logistic Models
  • Male
  • Neck Injuries / diagnosis*
  • Neck Injuries / diagnostic imaging
  • Neck Injuries / epidemiology*
  • Neck Injuries / pathology
  • Outcome Assessment, Health Care*
  • Practice Guidelines as Topic
  • Registries
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Tomography, X-Ray Computed / statistics & numerical data
  • Wounds, Nonpenetrating / diagnosis
  • Wounds, Nonpenetrating / diagnostic imaging
  • Wounds, Nonpenetrating / epidemiology
  • Wounds, Nonpenetrating / pathology