A cohort study of blunt cerebrovascular injury screening in children: Are they just little adults?

Cook, Mackenzie R.; Witt, Cordelie E.; Bonow, Robert H.; Bulger, Eileen M.; Linnau, Ken F.; Arbabi, Saman; Cuschieri, Joseph

doi:10.1097/ta.0000000000001631

Cited by 21 publications

(14 citation statements)

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“…Within the analyzed cohort of children with blunt head, face, or neck injuries and either imaging or follow-up, there were 30 BCVIs in 25 children (1.7%); 19 (76.0%) had Grade I or II injuries only, and 6 (24.0%) had at least a Grade IV or V injury. This proportion of BCVI grade is similar to that reported in other studies 3 …”

Section: Resultssupporting

confidence: 92%

“…This proportion of BCVI grade is similar to that reported in other studies. 3 Patients with and without BCVI were compared in Table 2. There were no significant differences between the two groups in age, sex, race, ethnicity, or insurance.…”

Section: Resultsmentioning

confidence: 99%

“…Cook et al 3 at Harborview Medical Center in Seattle also conducted a retrospective review of their pediatric trauma registry. The Denver, EAST, and Utah criteria were applied to patients within their registry who underwent CTA.…”

Section: Discussionmentioning

confidence: 99%

“…Timely diagnosis and initiation of treatment of BCVI have been shown to reduce the risk of stroke to as low as 0.3%, but screening in children has historically been low 2 . Pediatric BCVI rates may be similar to those in adults, with reported rates among well-studied pediatric blunt trauma patients of up to 1.3% 3 . National database studies have reported that the incidence of BCVI in children has increased in the past two decades, possibly because of increased awareness and screening.…”

mentioning

confidence: 99%

“…2 Pediatric BCVI rates may be similar to those in adults, with reported rates among well-studied pediatric blunt trauma patients of up to 1.3%. 3 National database studies have reported that the incidence of BCVI in children has increased in the past two decades, possibly because of increased awareness and screening. Although attribution cannot be made to BCVI in every case, pediatric stroke rates following BCVI may be as high as 29%, and mortality rates are between 3% and 19%.…”

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confidence: 99%

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Diagnostic accuracy of screening tools for pediatric blunt cerebrovascular injury: An ATOMAC multicenter study

Nickoles

Lewit

Notrica

et al. 2023

J Trauma Acute Care Surg

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BACKGROUND:Blunt cerebrovascular injury (BCVI) is rare but significant among children. There are three sets of BCVI screening criteria validated for adults (Denver, Memphis, and Eastern Association for the Surgery of Trauma criteria) and two that have been validated for use in pediatrics (Utah score and McGovern score), all of which were developed using retrospective, single-center data sets. The purpose of this study was to determine the diagnostic accuracy of each set of screening criteria in children using a prospective, multicenter pediatric data set. METHODS:A prospective, multi-institutional observational study of children younger than 15 years who sustained blunt trauma to the head, face, or neck and presented at one of six level I pediatric trauma centers from 2017 to 2020 was conducted. All patients were screened for BCVI using the Memphis criteria, but criteria for all five were collected for analysis. Patients underwent computed tomography angiography of the head or neck if the Memphis criteria were met at presentation or neurological abnormalities were detected at 2-week follow-up. RESULTS:A total of 2,284 patients at the 6 trauma centers met the inclusion criteria. After excluding cases with incomplete data, 1,461 cases had computed tomography angiography and/or 2-week clinical follow-up and were analyzed, including 24 cases (1.6%) with BCVI. Sensitivity, specificity, positive predictive value, and negative predictive value for each set of criteria were respectively 75.

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Section: Resultssupporting

confidence: 92%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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