Remember the vessels! Craniofacial fracture predicts risk for blunt cerebrovascular injury

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http://hdl.handle.net/10138/300473

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Varjonen , E A , Bensch , F , Pyhältö , T , Koivikko , M P & Snäll , J 2018 , ' Remember the vessels! Craniofacial fracture predicts risk for blunt cerebrovascular injury ' , Journal of Oral and Maxillofacial Surgery , vol. 76 , no. 7 , ARTN 1509.e1 . https://doi.org/10.1016/j.joms.2018.03.035

Title: Remember the vessels! Craniofacial fracture predicts risk for blunt cerebrovascular injury
Author: Varjonen, Elina A.; Bensch, Frank; Pyhältö, Tuomo; Koivikko, Mika P.; Snäll, Johanna
Contributor: University of Helsinki, HUS Medical Imaging Center
University of Helsinki, Clinicum
University of Helsinki, HUS Musculoskeletal and Plastic Surgery
University of Helsinki, HUS Medical Imaging Center
University of Helsinki, Clinicum
Date: 2018-07
Language: eng
Number of pages: 9
Belongs to series: Journal of Oral and Maxillofacial Surgery
ISSN: 0278-2391
URI: http://hdl.handle.net/10138/300473
Abstract: Purpose: The risk factors for blunt cerebrovascular injuries (BCVIs) are currently under intensive research, yet it is still controversial who should be screened. This study aimed to determine whether craniofacial fractures are associated with BCVI. Patients and Methods: This retrospective cohort study focused on patients with suspected polytrauma after whole-body computed tomographic angiography of the cervical arteries. Patients were reviewed for BCVI and craniofacial fractures. Exclusion criteria were hanging injury, gunshot injury or other penetrating injury to the neck, and a cervical fracture on any level. The outcome variable was BCVI, and the main predictor variable was a craniofacial fracture. A secondary predictor variable was a type of craniofacial fracture classified as a facial fracture, skull fracture, or a combination of facial and skull fracture. Other predictor variables were gender, age, and mechanism of injury In addition, specific craniofacial fractures were analyzed in more detail. The relevance of associations between BCVI and the predictors underwent chi(2) testing. Significance was set at .01. Results: Four hundred twenty-eight patients 13 to 90 years old during a 12-month period were included in the analysis. Craniofacial fractures occurred in 75 (17.5%). BCVI occurred significantly more frequently in those with than in those without a craniofacial fracture (18.6 vs 7.4%; P = .002). Patients with craniofacial fracture had a 4-fold increased risk for BCVI, whereas those 31 to 50 years old had 3.4-fold increased risk. Type of craniofacial fracture, gender, and mechanism of injury were not associated with BCVI. Conclusion: Craniofacial fractures are a serious risk factor for BCVI. This research suggests that in patients with any craniofacial fracture and suspected polytrauma, rigorous imaging of cervical arteries in search of BCVI is essential. (C) 2018 American Association of Oral and Maxillofacial Surgeons
Subject: ANGIOGRAPHY
ASSOCIATION
CAROTID-ARTERY INJURY
CERVICAL-SPINE
EARLY-DIAGNOSIS
GUIDELINES
IMPROVES
OUTCOMES
SCREENING CRITERIA
TRAUMA
3126 Surgery, anesthesiology, intensive care, radiology
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