Blunt cerebrovascular injuries: early recognition and stroke prevention in the emergency department

Emerg Med Pract. 2020 Dec 15;22(Suppl 12):1-43.

Abstract

Blunt cerebrovascular injuries include cervical carotid dissections and vertebral artery dissections that are due to blunt trauma. Although the overall incidence is low, dissections remain a common cause of stroke in children, young adults, and trauma patients. Symptoms of dissection, such as headache, neck pain, and dizziness, are commonly seen in the emergency department, but may not be apparent in the obtunded trauma patient or may not be recognized as being due to a dissection. A missed diagnosis of cervical artery dissection can result in devastating neurologic sequelae, and emergency clinicians must act quickly to recognize this diagnosis and begin treatment as soon as possible. This supplement reviews the application of advanced screening criteria, imaging options, and antithrombotic treatment for patients with blunt cerebrovascular injuries, with a focus on reducing the occurrence of ischemic stroke.

Publication types

  • Review

MeSH terms

  • Anticoagulants / therapeutic use
  • Carotid Artery, Internal, Dissection / complications
  • Carotid Artery, Internal, Dissection / diagnosis
  • Carotid Artery, Internal, Dissection / drug therapy
  • Craniocerebral Trauma / complications*
  • Craniocerebral Trauma / diagnosis
  • Craniocerebral Trauma / drug therapy
  • Diagnosis, Differential
  • Diagnostic Imaging
  • Early Diagnosis
  • Emergency Service, Hospital*
  • Evidence-Based Emergency Medicine
  • Humans
  • Medical History Taking
  • Physical Examination
  • Risk Factors
  • Stroke / etiology*
  • Stroke / prevention & control*
  • Vertebral Artery Dissection / complications
  • Vertebral Artery Dissection / diagnosis
  • Vertebral Artery Dissection / drug therapy
  • Wounds, Nonpenetrating / complications*
  • Wounds, Nonpenetrating / diagnosis
  • Wounds, Nonpenetrating / drug therapy

Substances

  • Anticoagulants