Rita Chiu, Presenter: Nothing to Disclose

Anja Judith Reimann MD, Abstract Co-Author: Nothing to Disclose

Savvas Nicolaou MD, Abstract Co-Author: Nothing to Disclose

Our study aims to assess the different mechanisms of blunt trauma and identify any that result in more severe vascular neck injuries.

Patients that have undergone blunt trauma from September 2004 to June 2010 were obtained from our institution’s trauma database. All patients’ CT neck angiographies were reviewed for presence of any carotid and/or vertebral injury or dissection, and the BIFFL grading score was assigned to each vascular injury as a marker of severity. Patients were divided based on their BIFFL score, and the different mechanisms of injury were tabulated for each group.

Out of 90 blunt trauma patients, 80 patients had a carotid and/or vertebral artery injury identified on CT Neck Angiography, and the BIFFL score for 69 of these blunt vascular neck injury (BVNI) patients were determined. There were 8, 25, 5, and 30 BVNI patients with BIFFL scores of 1, 2, 3, and 4 respectively. 10 out of 13 (77%) BVNI patients that fell from a height had a BIFFL score of 4. 10 out of 30 (34%) BVNI patients with BIFFL 4 had a fall from height, a mechanism that occurs less commonly in other BIFFL score groups (1 out of 7 [14%] for BIFFL 1, 2 out of 25 [8%] for BIFFL 2, 0 out of 5 [0%] for BIFFL 3). Of the 2 assaults that were assessed, both had BIFFL 4. Of the 34 BVNI patients involved in a motor vehicle accident (MVA), whether they were drivers, passengers, or pedestrians struck, 4 (12%), 16 (47%), 4 (12%), and 10 (29%) had BIFFL scores 1, 2, 3, and 4 respectively.

BVNI patients that had a fall from height or were victims of assault are more likely to have a severe vascular neck injury (i.e. BIFFL score 4). Although MVAs are the most common cause of blunt trauma, patients involved in MVAs did not demonstrate any predilection for more or less severe blunt vascular neck injuries.

Determining blunt trauma mechanisms that are more likely to cause severe neck vascular injuries will aid in predicting BVNI patient outcomes and need for more aggressive management.

Chiu, R, Reimann, A, Nicolaou, S, Predicting Severity of Blunt Vascular Neck Injuries Based on Mechanism of Blunt Trauma.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11005797.html