Neurointerventional management of cerebrovascular trauma
Abstract
Traumatic cerebrovascular injuries following blunt or penetrating trauma are common and carry a high risk of permanent disability or death. Proper screening, diagnosis, and treatment of these lesions is essential to improve patient outcomes. Advances in imaging continue to improve the accuracy of non-invasive diagnosis of these injuries while new clinical data provide better evidence for optimal management, whether medical or invasive. Here, we review screening, diagnosis, and treatment of traumatic cerebrovascular injuries.
Downloads
References
Patel J, Huynh TJ, Rao D, et al. Vascular trauma in the head and neck and endovascular neurointerventional management. J Clin Imaging Sci. 2020;10:44. doi:10.25259/JCIS_96_2020
Galgano M, Toshkezi G, Qiu X, et al. Traumatic brain injury: current treatment strategies and future endeavors. Cell Transplant. 2017;26:1118-30. doi:10.1177/0963689717714102.
Kansagra AP, Balasetti V, Huang MC. Neurovascular trauma: diagnosis and therapy. Handb Clin Neurol. 2021;176:325-44. doi:10.1016/B978-0-444-64034-5.00012-2
Vellimana AK, Lavie J, Chatterjee AR. Endovascular considerations in traumatic injury of the carotid and vertebral arteries. Semin Intervent Radiol. 2021;38:053-63. doi:10.1055/s-0041-1724008
Wu L, Christensen D, Call L, et al. Natural history of blunt cerebrovascular injury: experience over a 10-year period at a level I trauma center. Radiology. 2020;297:428-35. doi:10.1148/radiol.2020192866
Diaz-Daza O, Arraiza FJ, Barkley JM, et al. Endovascular therapy of traumatic vascular lesions of the head and neck. Cardiovasc Intervent Radiol. 2003;26:213-21. doi:10.1007/s00270-002-2619-0
Dahlin B, Waldau B. Surgical and nonsurgical treatment of vascular skull base trauma. J Neurol Surg B Skull Base. 2016;77:396-403. doi:10.1055/s-0036-1583539
Larsen DW. Traumatic vascular injuries and their management. Neuroimaging Clin N Am. 2002;12:249-69. doi:10.1016/S1052-5149(02)00006-0
Orlowski HLP, Kansagra AP, Sipe AL, et al. Utility of CT angiography in screening for traumatic cerebrovascular injury. Clin Neurol Neurosurg. 2018;172:27-30. doi:10.1016/j.clineuro.2018.06.001
Steenburg SD, Sliker CW, Shanmuganathan K, et al. Imaging evaluation of penetrating neck injuries. Radiographics. 2010;30:869-86. doi:10.1148/rg.304105022
Cothren CC, Moore EE, Ray CE, et al. Carotid artery stents for blunt cerebrovascular injury: risks exceed benefits. Arch Surg. 2005;140:480-5. discussion 485-486. doi:10.1001/archsurg.140.5.480
Kerwin AJ, Bynoe RP, Murray J, et al. Liberalized screening for blunt carotid and vertebral artery injuries is justified. J Trauma. 2001;51:308-14. doi:10.1097/00005373-200108000-00013
Berne JD, Norwood SH, McAuley CE, et al. The high morbidity of blunt cerebrovascular injury in an unscreened population: more evidence of the need for mandatory screening protocols. J Am Coll Surg. 2001;192:314-21. doi:10.1016/S1072-7515(01)00772-4
Figueroa JM, Berry K, Boddu J, et al. Treatment strategies for patients with concurrent blunt cerebrovascular and traumatic brain injury. J Clin Neurosci. 2021;88:243-50. doi:10.1016/j.jocn.2021.03.044
Burlew CC, Sumislawski JJ, Behnfield CD, et al. Time to stroke: a Western trauma association multicenter study of blunt cerebrovascular injuries. J Trauma Acute Care Surg. 2018;85:858-66. doi:10.1097/TA.0000000000001989
Bodanapally UK, Saksobhavivat N, Shanmuganathan K, et al. Arterial injuries after penetrating brain injury in civilians: risk factors on admission head computed tomography. J Neurosurg. 2015;122:219-26. doi:10.3171/2014.9.JNS14679
Cothren CC, Moore EE, Ray CE, et al. Screening for blunt cerebrovascular injuries is cost-effective. Am J Surg. 2005;190:849-54. doi:10.1016/j.amjsurg.2005.08.007
Kansagra AP, Cooke DL, English JD, et al. Current trends in endovascular management of traumatic cerebrovascular injury. J Neurointerv Surg. 2014;6:47-50. doi:10.1136/neurintsurg-2012-010605
Bromberg WJ, Collier BC, Diebel LN, et al. Blunt cerebrovascular injury practice management guidelines: the Eastern Association for the Surgery of Trauma. J Trauma. 2010;68:471-7. doi:10.1097/TA.0b013e3181cb43da
Shahan CP, Magnotti LJ, Stickley SM, et al. A safe and effective management strategy for blunt cerebrovascular injury: avoiding unnecessary anticoagulation and eliminating stroke. J Trauma Acute Care Surg. 2016;80:915-22. doi:10.1097/TA.0000000000001041
Sawiris N, Venizelos A, Ouyang B, et al. Current utility of diagnostic catheter cerebral angiography. J Stroke Cerebrovasc Dis. 2014;23:e145-50. doi:10.1016/j.jstrokecerebrovasdis.2013.09.012
Biffl WL, Ray CE, Moore EE, et al. Treatment-related outcomes from blunt cerebrovascular injuries: importance of routine follow-up arteriography. Ann Surg. 2002;235:699-706. doi:10.1097/00000658-200205000-00012
Biswas S, Chandran A, Radon M, et al. Accuracy of four-dimensional CT angiography in detection and characterisation of arteriovenous malformations and dural arteriovenous fistulas. Neuroradiol J. 2015;28:376-84. doi:10.1177/1971400915604526
Jindal G, Miller T, Raghavan P, et al. Imaging evaluation and treatment of vascular lesions at the skull base. Radiol Clin North Am. 2017;55:151-66. doi:10.1016/j.rcl.2016.08.003
Paulus EM, Fabian TC, Savage SA, et al. Blunt cerebrovascular injury screening with 64-channel multidetector computed tomography: more slices finally cut it. J Trauma Acute Care Surg. 2014;76:279-85. discussion 284-275. doi:10.1097/TA.0000000000000101
Uyeda JW, Anderson SW, Sakai O, et al. CT angiography in trauma. Radiol Clin North Am. 2010;48:423-38. ix-x. doi:10.1016/j.rcl.2010.02.003
Inaba K, Munera F, McKenney M, et al. Prospective evaluation of screening multislice helical computed tomographic angiography in the initial evaluation of penetrating neck injuries. J Trauma. 2006;61:144-9. doi:10.1097/01.ta.0000222711.01410.bc
Liang T, Plaa N, Tashakkor AY, et al. Imaging of blunt cerebrovascular injuries. Semin Roentgenol. 2012;47:306-19. doi:10.1053/j.ro.2012.05.001
Kim DY, Biffl W, Bokhari F, et al. Evaluation and management of blunt cerebrovascular injury: a practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2020;88:875-87. doi:10.1097/TA.0000000000002668
Sperry JL, Moore EE, Coimbra R, et al. Western Trauma Association critical decisions in trauma: penetrating neck trauma. J Trauma Acute Care Surg. 2013;75:936-40. doi:10.1097/TA.0b013e31829e20e3
Biffl WL, Moore EE, Offner PJ, et al. Blunt carotid arterial injuries: implications of a new grading scale. J Trauma. 1999;47:845-53. doi:10.1097/00005373-199911000-00004
Cothren CC, Biffl WL, Moore EE, et al. Treatment for blunt cerebrovascular injuries: equivalence of anticoagulation and antiplatelet agents. Arch Surg. 2009;144:685-90. doi:10.1001/archsurg.2009.111
Roon AJ, Christensen N. Evaluation and treatment of penetrating cervical injuries. J Trauma. 1979;19:391-7. doi:10.1097/00005373-197906000-00001
Schicho A, Luerken L, Meier R, et al. Incidence of traumatic carotid and vertebral artery dissections: results of cervical vessel computed tomography angiogram as a mandatory scan component in severely injured patients. Ther Clin Risk Manag. 2018;14:173-8. doi:10.2147/TCRM.S148176
Russo RM, Davidson AJ, Alam HB, et al. Blunt cerebrovascular injuries: outcomes from the American Association for the Surgery of Trauma PROspective Observational Vascular Injury Treatment (PROOVIT) multicenter registry. J Trauma Acute Care Surg. 2021;90:987-95. doi:10.1097/TA.0000000000003127
Murphy PB, Severance S, Holler E, et al. Treatment of asymptomatic blunt cerebrovascular injury (BCVI): a systematic review. Trauma Surg Acute Care Open. 2021;6:e000668. doi:10.1136/tsaco-2020-000668
Harrigan MR, Weinberg JA, Peaks Y-S, et al. Management of blunt extracranial traumatic cerebrovascular injury: a multidisciplinary survey of current practice. World J Emerg Surg. 2011;6:11. doi:10.1186/1749-7922-6-11
Barrera D, Sercy E, Orlando A, et al. Associations of antithrombotic timing and regimen with ischemic stroke and bleeding complications in blunt cerebrovascular injury. J Stroke Cerebrovasc Dis. 2020;29:104804. doi:10.1016/j.jstrokecerebrovasdis.2020.104804
Markus HS, Levi C, King A, et al. Antiplatelet therapy vs anticoagulation therapy in cervical artery dissection: the Cervical Artery Dissection In Stroke Study (CADISS) randomized clinical trial final results. JAMA Neurol. 2019;76:657-64. doi:10.1001/jamaneurol.2019.0072
Bonow RH, Witt CE, Mossa-Basha M, et al. Aspirin versus anticoagulation for stroke prophylaxis in blunt cerebrovascular injury: a propensity-matched retrospective cohort study. J Neurosurg. 2021:1413-20. doi:10.3171/2020.10.JNS201836
Roy AK, Grossberg JA, Osbun JW, et al. Carotid cavernous fistula after Pipeline placement: a single-center experience and review of the literature. J Neurointerv Surg. 2017;9:152-8. doi:10.1136/neurintsurg-2016-012586
Miller PR, Fabian TC, Bee TK, et al. Blunt cerebrovascular injuries: diagnosis and treatment. J Trauma. 2001;51:279-86. discussion 285-276. doi:10.1097/00005373-200108000-00009
Engelter ST, Traenka C, Lyrer P. Dissection of cervical and cerebral arteries. Curr Neurol Neurosci Rep. 2017;17:59. doi:10.1007/s11910-017-0769-3
Wahl WL, Brandt M-M, Thompson BG, et al. Antiplatelet therapy: an alternative to heparin for blunt carotid injury. J Trauma. 2002;52:896-901. doi:10.1097/00005373-200205000-00012
Moon K, Albuquerque FC, Cole T, et al. Stroke prevention by endovascular treatment of carotid and vertebral artery dissections. J Neurointerv Surg. 2017;9:952-7. doi:10.1136/neurintsurg-2016-012565
Kadkhodayan Y, Jeck DT, Moran CJ, et al. Angioplasty and stenting in carotid dissection with or without associated pseudoaneurysm. AJNR Am J Neuroradiol. 2005;26:2328-35. PMID: 16219841 PMCID: PMC7976134
Jadhav AP, Pryor JC, Nogueira RG. Onyx embolization for the endovascular treatment of infectious and traumatic aneurysms involving the cranial and cerebral vasculature. J Neurointerv Surg. 2013;5:562-5. doi:10.1136/neurintsurg-2012-010460
Kansagra AP, Wallace AN, Curfman DR, et al. Streamlined triage and transfer protocols improve door-to-puncture time for endovascular thrombectomy in acute ischemic stroke. Clin Neurol Neurosurg. 2018;166:71-5. doi:10.1016/j.clineuro.2018.01.026
Wang H, Thevathasan A, Dowling R, et al. Streamlining workflow for endovascular mechanical thrombectomy: lessons learned from a comprehensive stroke center. J Stroke Cerebrovasc Dis. 2017;26:1655-62. doi:10.1016/j.jstrokecerebrovasdis.2017.04.021
Konstas AA, Song A, Song J, et al. Republished: embolization of a cavernous carotid fistula through the vein of Labbé: a new alternative transvenous access route. J Neurointerv Surg. 2018;10:e11. doi:10.1136/neurintsurg-2017-013229.rep ar
Baranoski JF, Ducruet A, Przbylowski CJ, et al. Flow diverters as a scaffold for treating direct carotid cavernous fistulas. J Neurointerv Surg. 2019;11:1129-34. doi:10.1136/neurintsurg-2019-014731
Pham MH, Rahme RJ, Arnaout O, et al. Endovascular stenting of extracranial carotid and vertebral artery dissections: a systematic review of the literature. Neurosurgery. 2011;68:856-66. discussion 866. doi:10.1227/NEU.0b013e318209ce03
Scullen T, Mathkour M, Carr JR, et al. Iatrogenic middle cerebral artery ruptured pseudoaneurysm successfully treated with a Pipeline embolization device. Ochsner J. 2021;21:190-3. doi:10.31486/toj.19.0122
Nariai Y, Kawamura Y, Takigawa T, et al. Pipeline embolization for an iatrogenic intracranial internal carotid artery pseudoaneurysm after transsphenoidal pituitary tumor surgery: case report and review of the literature. Interv Neuroradiol. 2020;26:74-82. doi:10.1177/1591019919874943
Fields JD, Lutsep HL, Rymer MR, et al. Endovascular mechanical thrombectomy for the treatment of acute ischemic stroke due to arterial dissection. Interv Neuroradiol. 2012;18:74-9. doi:10.1177/159101991201800110
Ilyas A, Chen C-J, Raper DM, et al. Endovascular mechanical thrombectomy for cerebral venous sinus thrombosis: a systematic review. J Neurointerv Surg. 2017;9:1086-92. doi:10.1136/neurintsurg-2016-012938
Lee S-K, Mokin M, Hetts SW, et al. Current endovascular strategies for cerebral venous thrombosis: report of the SNIS Standards and Guidelines Committee. J Neurointerv Surg. 2018;10:803-10. doi:10.1136/neurintsurg-2018-013973
Foreman PM, Harrigan MR. Blunt traumatic extracranial cerebrovascular injury and ischemic stroke. Cerebrovasc Dis Extra. 2017;7:72-83. doi:10.1159/000455391
Esnault P, Cardinale M, Boret H, et al. Blunt cerebrovascular injuries in severe traumatic brain injury: incidence, risk factors, and evolution. J Neurosurg. 2017;127:16-22. doi:10.3171/2016.4.JNS152600
Rutman AM, Vranic JE, Mossa-Basha M. Imaging and management of blunt cerebrovascular injury. Radiographics. 2018;38:542-63. doi:10.1148/rg.2018170140
Nagpal P, Policeni BA, Bathla G, et al. Blunt cerebrovascular injuries: advances in screening, imaging, and management trends. AJNR Am J Neuroradiol. 2017. doi:10.3174/ajnr.A5412.

This work is licensed under a Creative Commons Attribution 4.0 International License.