• Radiology · Jan 2010

    Multidetector CT angiography in the evaluation of acute blunt head and neck trauma: a proposed acute craniocervical trauma scoring system.

    • Josser E Delgado Almandoz, Pamela W Schaefer, Hillary R Kelly, Michael H Lev, R Gilberto Gonzalez, and Javier M Romero.
    • Division of Neuroradiology, Department of Radiology, Massachusetts General Hospital, Gray 2 Room 273A, 55 Fruit St, Boston, MA 02114, USA. delgadoj@mir.wustl.edu
    • Radiology. 2010 Jan 1;254(1):236-44.

    PurposeTo determine the diagnostic yield of multidetector computed tomographic (CT) angiography in the evaluation of patients presenting to the emergency department with acute blunt head and neck trauma to assess for arterial injury and to propose a practical scoring system for the identification of patients at highest risk of arterial injury.Materials And MethodsWith institutional review board approval, Health Insurance Portability and Accountability Act compliance, and waived informed consent, a retrospective study was conducted of 830 consecutive patients who presented to the emergency department with acute blunt head and neck trauma over 9 years and were evaluated with multidetector CT angiography. Unenhanced CT scans and CT angiograms were reviewed for the presence of cervical interfacetal subluxations and/or dislocations, fractures, intracranial hemorrhage, and arterial injury. Medical records were reviewed for mechanism of injury (MOI). Multivariate logistic regression analysis was performed to identify independent predictors of an increased risk of arterial injury.ResultsMultidetector CT angiographic results showed injury to 118 arterial structures in 106 (12.8%) patients. Multivariate logistic regression analysis showed that the presence of cervical interfacetal subluxation/dislocations (44.4%; odds ratio [OR], 6.3; P < .0001), fracture lines reaching an arterial structure (22.1%; OR, 4.4; P < .0001), and high-impact MOIs (16.5%; OR, 3.1; P < .0001) were independent predictors of an increased risk of arterial injury and were used to construct a scoring system. Patients with scores of 2 and 3 (21.9% and 52.2%, respectively) were at highest risk of arterial injury.ConclusionThe proposed acute craniocervical trauma scoring system could be used as a guide to select blunt trauma patients for multidetector CT angiographic evaluation. Future validation of this scoring system is necessary.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…