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Eur J Trauma Emerg Surg · Aug 2022
Long-term outcome following blunt cerebrovascular injuries: occurrence of ischemic complications, treatment, and outcome.
- Camille Hego, Guillaume Rousseau, Paer-Selim Abback, Romain Pommier, Sophie-Rym Hamada, Benjamin Bergis, Igor Jurcisin, Alhassane Diallo, Catherine Paugam-Burtz, Stéphanie Sigaut, Tobias Gauss, and Jean-Denis Moyer.
- Department of Anesthesiology and Critical Care and Perioperative Care, Beaujon Hospital, 100, boulevard du Général-Leclerc, 92110, Clichy, France. camille.hego@aphp.fr.
- Eur J Trauma Emerg Surg. 2022 Aug 1; 48 (4): 3131-3140.
PurposeBlunt cerebrovascular injuries (BCVI) are a rare but serious complication after trauma. Among patients with BCVI, neurological status is altered in 30% of cases and the prognosis seems to be associated with ischemic complications. The aim of this study was to assess the long-term outcome of BCVI-associated ischemic events.MethodsThis retrospective cohort study (2011-2017) included all patients admitted for severe trauma with identified BCVI in two level-1 trauma centers. Patients were considered to have a poor neurological outcome with a GOS-E between 2 and 5 and a good neurological outcome with GOS-E between 6 and 8. A multivariate logistic regression identified risk factors for poor neurological outcome at 1 year.ResultsOf the 6,294 patients admitted in both trauma centers between 2011 and 2017, 81 patients presenting BCVI were identified (incidence of 1.3%). The median age was 35 years (24-44) with a median Injury Severity Score of 28 (17-41). 29 patients (50%) had a good neurological prognosis, while 25 patients (43%) had a poor neurological prognosis at 1 year. Ischemic stroke occurred in 11 patients (13.6%) within a median time of 2 days (2-2.5). No ischemic stroke occurred in the first year after ICU discharge in both groups. In our study, good prognosis at 1 year was not associated with ischemic complications [3 (10) vs 3 (12) p = 1].ConclusionIschemic complications after BCVI are rare, occur within the first week and do not seem to impact independently the 1-year neurological prognosis.© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
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