Traumatic cerebrovascular injury: Prevalence and risk factors

Tunthanathip, Thara; Phuenpathom, Nakornchai; Saehaeng, Sakchai; Oearsakul, Thakul; Sakarunchai, Ittichai; Kaewborisutsakul, Anukoon

doi:10.1016/j.ajem.2019.01.055

Cited by 9 publications

(9 citation statements)

References 33 publications

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“…According to Bodanapally et al 4 and Biffl et al, 3 TCVIs are divided into 4 groups: stenosis/occlusion, pseudoaneurysm, AVF, and transection. 28 Characteristics of TCVI injuries are demonstrated in Table 2. In the present study, the two most common types of TCVI were AVF (86.4%) and pseudoaneurysm (11.9%).…”

Section: Resultsmentioning

confidence: 99%

“…In this current study, we stratified the types of TCVI into 4 groups: stenosis/occlusion, pseudoaneurysm, AVF, and transection. 28 Cerebral angiography is the standard tool for detecting TCVI; however, this method is invasive and sometimes inappropriate in an acute setting. CTA was reported to be the appropriate initial diagnostic tool in an emergency setting because it is less time-consuming and less invasive.…”

Section: Discussionmentioning

confidence: 99%

“…However, vascular imaging of all patients with TBI would not represent a typical real-world situation. In patients considered to be at high risk for vascular injuries, such as those with penetrating injury, severe head injury, or basilar skull fracture, 4,15,17,28 cerebral angiography or CTA should be performed.…”

Section: Discussionmentioning

confidence: 99%

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Traumatic cerebrovascular injury: clinical characteristics and illustrative cases

Tunthanathip¹,

Phuenpathom²,

Saeheng³

et al. 2019

Neurosurgical Focus

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OBJECTIVETraumatic cerebrovascular injury (TCVI) is a rare and serious complication of traumatic brain injury (TBI). Various forms of TCVIs have been reported, including occlusions, arteriovenous fistulas, pseudoaneurysms, and transections. They can present at a variety of intervals after TBI and may manifest as sudden episodes, progressive symptoms, and even delayed fatal events. The purpose of this study was to analyze cases of TCVI identified at a single institution and further explore types and characteristics of these complications of TBI in order to improve recognition and treatment of these injuries.METHODSThe authors performed a retrospective review of cases of TCVI identified at their institution between 2013 and 2016. A total of 5178 patients presented with TBI during this time period, and 42 of these patients qualified for a diagnosis of TCVI and had adequate medical and imaging records for analysis. Data from their cases were analyzed, and 3 illustrative cases are presented in detail.RESULTSThe most common type of TCVI was arteriovenous fistula (86.4%), followed by pseudoaneurysm (11.9%), occlusion (2.4%), and transection (2.4%). The mortality rate of patients with TCVI was 7.1%.CONCLUSIONSThe authors describe the clinical characteristics of patients with TCVI and provide data from a series of 42 cases. It is important to recognize TCVI in order to facilitate early diagnosis and treatment.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Traumatic cerebrovascular injury: clinical characteristics and illustrative cases

Tunthanathip¹,

Phuenpathom²,

Saeheng³

et al. 2019

Neurosurgical Focus

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“…Trauma-related pseudoaneurysms of intracranial arteries are extremely rare, and are known to be associated with blunt or penetrating head injuries 2) . The reported prevalence of traumatic cerebrovascular injury is 0.8% among all traumatic brain injury (TBI) patients 10) . The clinical presentation shows a wide range of signs and symptoms, including headache, loss of consciousness, altered mentality, and subarachnoid hemorrhage (SAH) in brain computed tomography (CT), and such neurological deficits may appear either immediately, or months to years later 1) .…”

Section: Introductionmentioning

confidence: 99%

Internal Carotid Artery Dissection with Traumatic Pseudoaneurysm Formation after Penetrating Head Injury

Ham

Kim

Yoon

2019

J Neurointensive Care

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Traumatic pseudoaneurysm of the intracranial arteries is a devastating event leading to high mortality. Its prevalence is rare, and associated with blunt or penetrating head injuries. Here, we describe a case of a 46-year-old woman who was transferred to our hospital following a stab-induced head trauma. Owing to multiple assaults by a sharp knife, the patient presented with an injured intracranial internal carotid artery that formed dissecting pseudoaneurysms. Stupor mentality was noted, and brain computed tomography revealed traumatic subarachnoid hemorrhage, and intracerebral hemorrhage in a "knife shape". Diagnostic angiography showed an active extravasation in the middle cerebral artery and distal internal carotid artery with two pseudoaneurysms. Immediate trapping was planned, and embolization was performed with detachable coils. The patient was transferred to the operation room and emergent decompressive craniectomy with wide durotomy was performed. Unfortunately, the patient expired few days after the operation despite maximal neurocritical care.

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“…[4] In terms of the continuing conflict in southern Thailand, the patients injured from blast-induced traumatic brain injury (bTBI) have been reported. [4–6] The blast effects can cause injuries, including open-scalp wounds, skull fractures, dural tearing, and CSF leakage. [6,7] Such a wound that becomes contaminated results in SSI.…”

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confidence: 99%

Factors associated with surgical site infection in blast-induced traumatic brain injury

Tunthanathip

Tepaamondej

2019

Chinese Medical Journal

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Traumatic cerebrovascular injury: Prevalence and risk factors

Cited by 9 publications

References 33 publications

Traumatic cerebrovascular injury: clinical characteristics and illustrative cases

Traumatic cerebrovascular injury: clinical characteristics and illustrative cases

Internal Carotid Artery Dissection with Traumatic Pseudoaneurysm Formation after Penetrating Head Injury

Factors associated with surgical site infection in blast-induced traumatic brain injury

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