Blunt Cerebrovascular Injury (BCVI): Universal CTA Neck Screening at Level 2 Trauma Center

Abstract

Blunt Cerebrovascular Injury (BCVI) refers to injuries to the vessels supplying blood to the brain, primarily carotid and vertebral arteries, and can result from trauma, resulting in stroke by vessel dissection, thrombus formation, embolization, and hemorrhage. Timely identification is crucial for effective intervention and improved outcomes. This doctoral project proposes the implementation of universal screening using Computed Tomography Angiography (CTA) of the neck during initial workup for blunt force trauma at a Level II ACS-verified trauma center. The primary objective is to mitigate potential delays in diagnosing and treating BCVI, thereby reducing the likelihood of complications. Patients ≥ 15 years old with significant blunt-force trauma activations from March 2023-January 2024 will receive CTA neck with a 128-slice computed tomography scanner during initial trauma workup. During the study period, 395 patients had level I and level II trauma activations, 210 (53.16%) of which met the criteria for BCVI screening. CTA neck was completed on 156 individuals (74.29%),11 (7.05%) of which exhibited evidence of BCVI. The variables BCVI Followed and “Positive BCVI displayed a significant correlation (r=0.97 and p\u3c0.001). A strong positive linear relationship between the two variables was observed. The implementation of universal screening with CTA neck for BCVI detection holds promise for advancing trauma care practices. This doctoral project provides evidence-based recommendations and insights to guide similar initiatives in trauma centers, improving patient outcomes and reinforcing the commitment to excellence in trauma care