Vascular Injuries in Head and Neck Trauma

Rodrı́guez, A.; Nuñez, Luis; Riascos, Roy

doi:10.1016/j.rcl.2023.01.012

Cited by 3 publications

(6 citation statements)

References 41 publications

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“…The management of traumatic vascular injuries in the head and neck region represents a significant challenge in trauma care due to the complex anatomy of the region and the essential functions of the vessels involved. These injuries carry the risk of serious complications such as excessive bleeding, potential stroke, and the possibility of death [1,4]. Our experience in treating 21 patients over a decade underscores the efficacy of endovascular treatment in managing various traumatic vascular injuries in this area.…”

Section: Discussionmentioning

confidence: 94%

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Endovascular Treatment of Traumatic Vascular Injuries in the Head and Neck Region

Koh,

Choi,

Shin

et al. 2024

Medicina

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Background and Objectives: Traumatic vascular injuries of the head and neck pose significant treatment challenges due to the complex anatomy, diverse clinical presentation, and mostly emergent nature. Endovascular treatment increasingly complements traditional surgical approaches. This study aimed to report our 10-year experience in treating traumatic vascular injuries of the head and neck with endovascular therapy and to determine the effectiveness of endovascular treatment. Materials and Methods: A retrospective analysis of 21 patients treated for head and neck vascular injuries between May 2011 and April 2021 was performed. Patients’ medical histories, clinical presentations, imaging findings, treatment materials, and clinical outcomes were reviewed. Treatments included stenting, coil embolization, and other endovascular techniques focused on hemostasis and preservation of the parent vessel. Results: The most common injuries involved the internal maxillary artery branches (n = 11), followed by the common or internal carotid artery (n = 6), vertebral artery (n = 3), and others. Endovascular treatment achieved successful hemostasis in all but one case. In five of six carotid artery injuries and two of three vertebral artery injuries, we achieved successful hemostasis while preserving the parent vessel using covered and bare stents, respectively. Conclusions: Endovascular therapy might be a useful treatment modality for traumatic vascular injuries in the head and neck region, offering efficacy, safety, and a minimally invasive approach.

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Section: Discussionmentioning

confidence: 94%

“…The causes of such traumatic injuries range from blunt to penetrating trauma, each of which can have devastating consequences if not treated promptly and effectively. This multifaceted challenge underscores the need for meticulous and innovative treatment approaches to manage these critical injuries [1,2].…”

Section: Introductionmentioning

confidence: 99%

Endovascular Treatment of Traumatic Vascular Injuries in the Head and Neck Region

Koh,

Choi,

Shin

et al. 2024

Medicina

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“…One of the most common concerns is artifact in those with retained metallic fragments. In these patients, as well as those 3,9,16,19,23,35,44,52,56,60,61,64,[68][69][70][71][72][73][74] Vascular Aerodigestive Sensitivity Specificity Sensitivity Specificity Physical examination 43-97% 23,44,46,56…”

Section: Discussionmentioning

confidence: 99%

“…Limitations of MDCTA include artifact and beam hardening from metal fragments, dental amalgams, or orthopedic hardware; incorrect contrast bolus timing; and the potential for motion artifact. 16 For diagnosis of vascular injury, the sensitivity of MDCTA is 90% to 100% and the specificity is 97% to 100%. 60,61 Direct signs of arterial injury on MDCTA include dissection, intramural hematoma, pseudoaneurysm, occlusion, transection, and arteriovenous fistula.…”

Section: Characteristics Of Mdcta For Penetrating Neck Injurymentioning

confidence: 99%

“…Stab wounds cause clinically significant vascular or visceral injuries in 10% to 20% of cases, and gunshot wounds, in about 50% 2,9 . Arterial injury is found in 15% to 25% of all penetrating neck trauma 7,15 and deep venous injury in 16% to 33% 16–18 . Aerodigestive tract injuries are found in about 5% to 18% of penetrating neck injuries, with a predominance of these injuries affecting the trachea, likely because of the anatomic relationship between the trachea and esophagus 3,19 .…”

Section: Epidemiologymentioning

confidence: 99%

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Diagnostic approach to penetrating neck trauma: What you need to know

Siletz,

Inaba

2024

J Trauma Acute Care Surg

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Diagnostic evaluation of penetrating neck trauma has evolved considerably over the last several decades. The contemporary approach to these injuries is based primarily on clinical signs of injury and multidetector computed tomographic angiography (MDCTA). The neck is evaluated as a unit, rather than relying on the surface anatomy zones in which external injuries are seen to guide the workup of internal injuries. This “no-zone” approach safely spares many patients from negative explorations and unnecessary invasive tests. The purpose of this review is to describe an evidence-based approach to the diagnostic evaluation of penetrating neck trauma, including indications for adjunctive testing beyond physical exam and MDCTA.

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Changes in occurrence and management of laryngeal fractures at the Helsinki University Hospital during 25 years

Mäkitie,

Nyman,

Ilmarinen

et al. 2023

Eur Arch Otorhinolaryngol

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Purpose Laryngeal fracture is a rare but potentially life-threatening trauma. Fractures vary from mild to dislocated and extensive with risk of severe complications. This study investigated the occurrence, clinical characteristics and management of laryngeal fractures in the last 15 years. Material and methods A retrospective population-based cohort study reviewing all laryngeal fractures at the Helsinki University Hospital in 2005–2019. Patient records and imaging studies were systematically reviewed for mode of injury, fracture type, secondary complications, treatment modality, possible airway management, length of stay, and mortality. Results were compared with corresponding data from 1995 to 2004. Results Overall 80 fracture patients were recorded (5.3/year); 79% were men and mean age was 42 years (range 18–78). Altogether 91% were closed and 9% open. While unintentional traumas were most common (54%), an increasing proportion were from intentional injury (10%) or Schaefer Gr IV in severity (35%). Altogether 46% had compromised airway and 21% needed airway intervention; airway narrowing was more common with cricoid (p = 0.042) and multiple fractures (p = 0.07) and correlated positively with amount of dislocation (p = 0.001) and number of fracture lines (p = 0.006). Surgery was performed for 33%, of which 46% were Schaefer Gr IV and 62% from intentional trauma. Mortality was 1.4%. Conclusions Deliberate and violence-related laryngeal fractures have increased. These often result in more extensive injuries predisposing to compromised airway and requiring surgical intervention and longer treatment. Most fractures are still treated conservatively with good long-term outcomes. An observation period of 24 h is recommended to detect any delayed complications. Mortality remains low.

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Vascular Injuries in Head and Neck Trauma

Cited by 3 publications

References 41 publications

Endovascular Treatment of Traumatic Vascular Injuries in the Head and Neck Region

Endovascular Treatment of Traumatic Vascular Injuries in the Head and Neck Region

Diagnostic approach to penetrating neck trauma: What you need to know

Changes in occurrence and management of laryngeal fractures at the Helsinki University Hospital during 25 years

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