Citation

Steenburg SD, Sliker CW. Eur. Radiol. 2012; 22(9): 1837-1843.

Affiliation

Diagnostic Imaging Department, University of Maryland Medical Center and R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD, 21201, USA, ssteenbu@iuhealth.org.

Copyright

(Copyright © 2012, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s00330-012-2439-9

PMID

22569994

Abstract

OBJECTIVES: To review our institutional experience with cervical arterial injuries remote from the penetrating tract seen in the setting of craniofacial gunshot injuries. METHODS: Institutional Review Board approval was obtained. Our institutional trauma registry was queried over a 5-year period for patients with cervical arterial injuries due to penetrating craniofacial gunshot wounds who underwent CT angiography. Imaging results and clinical notes were reviewed. RESULTS: A total of 427 patients sustained gunshot wounds to the head, face and/or neck, of whom 222 underwent CT angiography yielding 56 patients with 78 vascular injuries. There were five internal carotid artery injuries remote from the wound tract. The incidence of these "indirect" cervical arterial injuries in our patient population was 1.2%, or 2.8% of patients who underwent CT angiography. CONCLUSIONS: The incidence of "indirect" cervical arterial injuries with craniofacial gunshot wounds is comparable to or slightly higher than those seen in pure blunt trauma. Screening patients with craniofacial gunshot injuries with CT angiography may yield unexpected cervical vascular injuries remote from the penetrating tract. The significance and optimal therapy of these injuries are unknown. Additional experience will be needed to determine the significance of "indirect" cervical arterial injuries in the setting of craniofacial gunshot wounds. KEY POINTS: • There are several known risk factors for blunt cervical arterial injuries. • Cervical arterial injuries may occur remote from the wound following craniofacial gunshot wounds. • Craniofacial gunshot wounds pose a risk for blunt cervical vascular injuries.

Language: en