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Emergent neurovascular imaging in patients with blunt traumatic injuries
Blunt cerebrovascular injuries (BCVIs) are commonly encountered after blunt trauma. Given the increased risk of stroke incurred after BCVI, it is crucial that they are promptly identified, characterized, and treated appropriately. Current screening practices generally consist of computed tomography...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10365007/ https://www.ncbi.nlm.nih.gov/pubmed/37492683 http://dx.doi.org/10.3389/fradi.2022.1001114 |
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author | Bounajem, Michael T. McNally, J. Scott Baker, Cordell Colby, Samantha Grandhi, Ramesh |
author_facet | Bounajem, Michael T. McNally, J. Scott Baker, Cordell Colby, Samantha Grandhi, Ramesh |
author_sort | Bounajem, Michael T. |
collection | PubMed |
description | Blunt cerebrovascular injuries (BCVIs) are commonly encountered after blunt trauma. Given the increased risk of stroke incurred after BCVI, it is crucial that they are promptly identified, characterized, and treated appropriately. Current screening practices generally consist of computed tomography angiography (CTA), with escalation to digital subtraction angiography for higher-grade injuries. Although it is quick, cost-effective, and readily available, CTA suffers from poor sensitivity and positive predictive value. A review of the current literature was conducted to examine the current state of emergent imaging for BCVI. After excluding reviews, irrelevant articles, and articles exclusively available in non-English languages, 36 articles were reviewed and included in the analysis. In general, as CTA technology has advanced, so too has detection of BCVI. Magnetic resonance imaging (MRI) with sequences such as vessel wall imaging, double-inversion recovery with black blood imaging, and magnetization prepared rapid acquisition echo have notably improved the utility for MRI in characterizing BCVIs. Finally, transcranial Doppler with emboli detection has proven to be associated with strokes in anterior circulation injuries, further allowing for the identification of high-risk lesions. Overall, imaging for BCVI has benefited from a tremendous amount of innovation, resulting in better detection and characterization of this pathology. |
format | Online Article Text |
id | pubmed-10365007 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-103650072023-07-25 Emergent neurovascular imaging in patients with blunt traumatic injuries Bounajem, Michael T. McNally, J. Scott Baker, Cordell Colby, Samantha Grandhi, Ramesh Front Radiol Radiology Blunt cerebrovascular injuries (BCVIs) are commonly encountered after blunt trauma. Given the increased risk of stroke incurred after BCVI, it is crucial that they are promptly identified, characterized, and treated appropriately. Current screening practices generally consist of computed tomography angiography (CTA), with escalation to digital subtraction angiography for higher-grade injuries. Although it is quick, cost-effective, and readily available, CTA suffers from poor sensitivity and positive predictive value. A review of the current literature was conducted to examine the current state of emergent imaging for BCVI. After excluding reviews, irrelevant articles, and articles exclusively available in non-English languages, 36 articles were reviewed and included in the analysis. In general, as CTA technology has advanced, so too has detection of BCVI. Magnetic resonance imaging (MRI) with sequences such as vessel wall imaging, double-inversion recovery with black blood imaging, and magnetization prepared rapid acquisition echo have notably improved the utility for MRI in characterizing BCVIs. Finally, transcranial Doppler with emboli detection has proven to be associated with strokes in anterior circulation injuries, further allowing for the identification of high-risk lesions. Overall, imaging for BCVI has benefited from a tremendous amount of innovation, resulting in better detection and characterization of this pathology. Frontiers Media S.A. 2022-09-15 /pmc/articles/PMC10365007/ /pubmed/37492683 http://dx.doi.org/10.3389/fradi.2022.1001114 Text en © 2022 Bounajem, McNally, Baker, Colby and Grandhi. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Radiology Bounajem, Michael T. McNally, J. Scott Baker, Cordell Colby, Samantha Grandhi, Ramesh Emergent neurovascular imaging in patients with blunt traumatic injuries |
title | Emergent neurovascular imaging in patients with blunt traumatic injuries |
title_full | Emergent neurovascular imaging in patients with blunt traumatic injuries |
title_fullStr | Emergent neurovascular imaging in patients with blunt traumatic injuries |
title_full_unstemmed | Emergent neurovascular imaging in patients with blunt traumatic injuries |
title_short | Emergent neurovascular imaging in patients with blunt traumatic injuries |
title_sort | emergent neurovascular imaging in patients with blunt traumatic injuries |
topic | Radiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10365007/ https://www.ncbi.nlm.nih.gov/pubmed/37492683 http://dx.doi.org/10.3389/fradi.2022.1001114 |
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