Screening, Diagnosis, and Management of Blunt Cerebrovascular Injury

Martin Croce, MD Professor of Surgery in the Division of Trauma and Critical Care at the University of Tennessee in Memphis presents on Blunt Cerebrovascular Injuries (BCVI) at the 2012 annual Southwest Trauma & Acute Care Symposium. The main question is whether these injuries need to be diagnosed. The short answer is yes. Some issues include screening for BCVI, diagnosis of BCVI, and management of BCVI. Angiography is the gold standard, but it is both time consuming and invasive. As CT scans continue to improve, these may be an alternative. Traditional screening methods for BCVI still miss 20% of injuries. Using CTA will catch an additional 16%, but does not completely catch all cases. Also, this is a screening criterion, not a screening test. Anticoagulation Therapy is one way to manage BCVI. Antithrombotic therapy with selective stent placement for injuries that are more severe is the mainstay.