Best practice guidelines for blunt cerebrovascular injury (BCVI)

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  • Tor Brommeland, Eastern and Southern Norway
  • ,
  • Eirik Helseth, Eastern and Southern Norway, Universitetet i Oslo
  • ,
  • Mads Aarhus, Eastern and Southern Norway
  • ,
  • Kent Gøran Moen, Norwegian University of Science and Technology, Department of Medical Imaging
  • ,
  • Stig Dyrskog
  • Bo Bergholt
  • Zandra Olivecrona, Faculty of Health and Medicine
  • ,
  • Elisabeth Jeppesen, University of Oslo, Oslo University Hospital, Oslo

Blunt cerebrovascular injury (BCVI) is a non-penetrating injury to the carotid and/or vertebral artery that may cause stroke in trauma patients. Historically BCVI has been considered rare but more recent publications indicate an overall incidence of 1-2% in the in-hospital trauma population and as high as 9% in patients with severe head injury. The indications for screening, treatment and follow-up of these patients have been controversial for years with few clear recommendations. In an attempt to provide a clinically oriented guideline for the handling of BCVI patients a working committee was created. The current guideline is the end result of this committees work. It is based on a systematic literature search and critical review of all available publications in addition to a standardized consensus process. We recommend using the expanded Denver screening criteria and CT angiography (CTA) for the detection of BCVI. Early antithrombotic treatment should be commenced as soon as considered safe and continued for at least 3months. A CTA at 7days to confirm or discard the diagnosis as well as a final imaging control at 3months should be performed.

Original languageEnglish
Article number90
JournalScandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Volume26
Issue1
ISSN1757-7241
DOIs
Publication statusPublished - 29 Oct 2018

    Research areas

  • CT angiography, Guidelines, Screening, Trauma, Vascular injury

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