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Open Access 01-06-2013 | Original Article

Blunt cerebrovascular injury: diagnosis at whole-body MDCT for multi-trauma

Authors: Matteo Bonatti, Norberto Vezzali, Federica Ferro, Riccardo Manfredi, Nadia Oberhofer, Giampietro Bonatti

Published in: Insights into Imaging | Issue 3/2013

Abstract

Purpose

To analyse the prevalence of blunt cerebrovascular injuries (BCVIs) in multi-trauma patients by means of a post-contrast acquisition of neck vessels included into the whole-body multi-detector computed tomography (MDCT) protocol performed at admission and to correlate it with the presence of risk factors (Memphis approach).

Materials and methods

A retrospective study was undertaken for the period January 2005 to November 2011, involving 976 multi-trauma patients. Post-contrast images of neck vessels in MDCT scan were evaluated by two experienced radiologists; carotid, vertebral and basilar arteries were rated according to the Biffl classification. The presence of clinical and/or CT risk factors for BCVI was assessed.

Results

BCVI were present in 32/976 (3.3 %) multi-trauma patients. Risk factors for BCVI were present in 247/976 (25.3 %) patients. The group of patients presenting risk factors showed a significantly higher prevalence of cerebrovascular injuries (8.1 %) compared with the group of patients without risk factors (1.6 %) (p = 0.009); however, 12/32 (37.5 %) patients presenting BCVI did not show any of the risk factors proposed by the Memphis group.

Conclusion

An investigation for the presence of BCVI should be performed on all multi-trauma patients despite the absence of clinical-radiological risk factors.

Key Points

BCVIs are present in 3.3 % of multi-trauma patients.
BCVIs are significantly associated to the Memphis risk factors.
Of the multi-trauma patients affected by BCVIs, 37.5 % do not show clinical-radiological risk factors.
A screening for BCVI should be performed on all multi-trauma patients.

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Title: Blunt cerebrovascular injury: diagnosis at whole-body MDCT for multi-trauma
Authors: Matteo Bonatti
Norberto Vezzali
Federica Ferro
Riccardo Manfredi
Nadia Oberhofer
Giampietro Bonatti
Publication date: 01-06-2013
Publisher: Springer Berlin Heidelberg
Published in: Insights into Imaging / Issue 3/2013
Electronic ISSN: 1869-4101
DOI: https://doi.org/10.1007/s13244-013-0235-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Blunt cerebrovascular injury: diagnosis at whole-body MDCT for multi-trauma

Abstract

Purpose

Materials and methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

Key Points

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