Citation

Kopelman TR, Leeds S, Berardoni NE, O'Neill PJ, Hedayati P, Vail SJ, Pieri PG, Feiz-Erfan I, Pressman MA. Am. J. Surg. 2011; 202(6): 684-689.

Affiliation

Division of Burns, Trauma, and Surgical Critical Care, Maricopa Medical Center, 2601 E Roosevelt St., Phoenix, AZ 85008, USA.

Copyright

(Copyright © 2011, Elsevier Publishing)

DOI

10.1016/j.amjsurg.2011.06.033

PMID

22137135

Abstract

BACKGROUND: It has been suggested that specific cervical spine fractures (CSfx) (location at upper cervical spine [CS], subluxation, or involvement of the transverse foramen) are predictive of blunt cerebrovascular injury (BCVI). We sought to determine the incidence of BCVI with CSfx in the absence of high-risk injury patterns. METHODS: We performed a retrospective study in patients with CSfx who underwent evaluation for BCVI. The presence of recognized CS risk factors for BCVI and other risk factors (Glasgow coma score ≤ 8, skull-based fracture, complex facial fractures, soft-tissue neck injury) were reviewed. Patients were divided into 2 groups based on the presence/absence of risk factors. RESULTS: A total of 260 patients had CSfx. When screened for high-risk pattern of injury for BCVI, 168 patients were identified and 13 had a BCVI (8%). The remaining 92 patients had isolated low CSfx (C4-C7) without other risk factors for BCVI. In this group, 2 patients were diagnosed with BCVI (2%). Failure to screen all patients with CSfx would have missed 2 of 15 BCVIs (13%). CONCLUSIONS: We propose that all CS fracture patterns warrant screening for BCVI.

Language: en