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. 2022 Aug;48(4):3131-3140.
doi: 10.1007/s00068-021-01860-4. Epub 2022 Jan 22.

Long-term outcome following blunt cerebrovascular injuries: occurrence of ischemic complications, treatment, and outcome

Camille Hego  1 , Guillaume Rousseau  2 , Paer-Selim Abback  2 , Romain Pommier  3 , Sophie-Rym Hamada  4   5 , Benjamin Bergis  4   5 , Igor Jurcisin  2 , Alhassane Diallo  6 , Catherine Paugam-Burtz  2   7 , Stéphanie Sigaut  2 , Tobias Gauss  2 , Jean-Denis Moyer  2
Affiliations

Long-term outcome following blunt cerebrovascular injuries: occurrence of ischemic complications, treatment, and outcome

Camille Hego et al. Eur J Trauma Emerg Surg. 2022 Aug.

Abstract

Purpose: Blunt 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.

Methods: This 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.

Results: Of 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].

Conclusion: Ischemic complications after BCVI are rare, occur within the first week and do not seem to impact independently the 1-year neurological prognosis.

Keywords: Blunt cerebrovascular injury; Carotid and vertebral arteries; Neurological outcome; Severe trauma; Stroke.

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