Dorith Goldsher MD, Presenter: Nothing to Disclose

Marcelo Daitzchman MD, Abstract Co-Author: Nothing to Disclose

Ayelet Eran MD, Abstract Co-Author: Nothing to Disclose

Yolanda Abrantes MD, Abstract Co-Author: Nothing to Disclose

Reuven Shreiber MD, Abstract Co-Author: Nothing to Disclose

To assess the contribution of CT Angiography [CTA] to the evaluation of vascular insult in patients with craniocervical injuries.

Of 2321 patients admitted to our Emergency Room between January 2002 and March 2003 with craniocervical trauma, 73 patients underwent CTA. Twenty-six had penetrating cervical trauma and 38 had penetrating skull injuries with bony and/or metal shrapnel adjacent to major blood vessels. Nine patients underwent CTA because of base-of-skull or cervical spine fractures involving the pathways of carotid or vertebral arteries. CTA studies were performed on a multi-detector CT system: MX 8000 or MX 8000 IDT (Philips Ltd) with 4 and 16 multislice capability, respectively. Covered volume extended from the aortic arch to a level above the circle of Willis in cases of cervical trauma, and from the C2 level to the brain convexity in brain injury. The images were read and interpreted by two neuroradiologists independently. Eleven patients had digital subtracted angiography.

Three pseudoaneurysms and nine arterial dissections were diagnosed on both modalities. Traumatic arterial occlusion by foreign body was found in three patients. In all cases CTA demonstrated the type of the vascular injury, the anatomical location, and the relationship to the damaged surrounding structures. In patients with penetrating injuries CTA disclosed the route of the penetrating object and the damage caused along the route.

CTA is suggested as a minimally invasive and rapid imaging modality for the assessment of vascular injuries and treatment planning in severe craniocervical trauma patients.

Goldsher, D, Daitzchman , M, Eran, A, Abrantes, Y, Shreiber, R, The Impact of Multislice CT Angiography on the Management of Vascular Injury in Patients with Severe Craniocervical Trauma.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4416368.html