• Tej D Azad, Divyaansh Raj, Kowsar Ahmed, Kathleen Ran, Joshua Materi, Joseph Dardick, Joshua Olexa, Farah Musharbash, Daniel Lubelski, Timothy Witham, Ali Bydon, Nicholas Theodore, James P Byrne, and Elliott Haut.
• Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, Maryland, USA.
• World Neurosurg. 2023 Jan 1; 169: e251e259e251-e259.

BackgroundBlunt cerebrovascular injury (BCVI), defined as blunt traumatic injury to the carotid or vertebral arteries, is associated with significant risk of stroke and mortality. Cervical spine trauma is a recognized risk factor for BCVI.ObjectiveThe objective of this study was to identify significant predictors of BCVI and its sequelae in patients with known cervical spine injury.MethodsPatients from 2007 to 2018 with blunt cervical spine injury diagnoses were identified in the National Trauma Data Bank. Multivariable logistic regression models were used to identify patient baseline and injury characteristics associated with BCVI, stroke, and mortality.ResultsWe identified 229,254 patients with cervical spine injury due to blunt trauma. The overall rate of BCVI was 1.6%. Factors associated with BCVI in patients with cervical spine injury included lower Glasgow Coma Scale, motor vehicle crash, higher Injury Severity Score, concomitant traumatic brain or spinal cord injury, and current smoking status. BCVI was a strong predictor of stroke (odds ratio, 8.2; 95% confidence interval, 5.7-12.0) and was associated with mortality (odds ratio, 1.7; 95% confidence interval, 1.3-2.2). Stroke occurred in 3.3% of patients with BCVI versus 0.02% for patients without BCVI.ConclusionsWhile BCVI is rare following cervical spine injury due to blunt trauma, it is a significant predictor of stroke and mortality. The risk factors associated with BCVI, stroke, and mortality identified here should be used in the development of more effective predictive tools to improve care.Copyright © 2022 Elsevier Inc. All rights reserved.

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