Craniofacial gunshot injuries: An unrecognised risk factor for blunt cervical vascular injuries?

Scott D. Steenburg, Clint W. Sliker

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

Objectives To review our institutional experience with cervical arterial injuries remote from the penetrating tract seen in the setting of craniofacial gunshot injuries. Methods Institutional Review Board approval was obtained. Our institutional trauma registry was queried over a 5-year period for patients with cervical arterial injuries due to penetrating craniofacial gunshot wounds who underwent CT angiography. Imaging results and clinical notes were reviewed. Results A total of 427 patients sustained gunshot wounds to the head, face and/or neck, of whom 222 underwent CT angiography yielding 56 patients with 78 vascular injuries. There were five internal carotid artery injuries remote from the wound tract. The incidence of these "indirect" cervical arterial injuries in our patient population was 1.2%, or 2.8% of patients who underwent CT angiography. Conclusions The incidence of "indirect" cervical arterial injuries with craniofacial gunshot wounds is comparable to or slightly higher than those seen in pure blunt trauma. Screening patients with craniofacial gunshot injuries with CTangiography may yield unexpected cervical vascular injuries remote from the penetrating tract. The significance and optimal therapy of these injuries are unknown. Additional experience will be needed to determine the significance of "indirect" cervical arterial injuries in the setting of craniofacial gunshot wounds. Key Points ̇ There are several known risk factors for blunt cervical arterial injuries. ̇ Cervical arterial injuries may occur remote from the wound following craniofacial gunshot wounds. ̇ Craniofacial gunshot wounds pose a risk for blunt cervical vascular injuries.

Original languageEnglish (US)
Pages (from-to)1837-1843
Number of pages7
JournalEuropean Radiology
Volume22
Issue number9
DOIs
StatePublished - Sep 1 2012

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Vascular System Injuries
Wounds and Injuries
Gunshot Wounds
Carotid Artery Injuries
Research Ethics Committees
Incidence
Internal Carotid Artery
Registries
Neck

Keywords

  • Blunt cerebrovascular injury
  • Cervical vascular injury
  • Craniofacial trauma
  • CT angiography
  • Gunshot wound

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Craniofacial gunshot injuries : An unrecognised risk factor for blunt cervical vascular injuries? / Steenburg, Scott D.; Sliker, Clint W.

In: European Radiology, Vol. 22, No. 9, 01.09.2012, p. 1837-1843.

Research output: Contribution to journalReview article

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AB - Objectives To review our institutional experience with cervical arterial injuries remote from the penetrating tract seen in the setting of craniofacial gunshot injuries. Methods Institutional Review Board approval was obtained. Our institutional trauma registry was queried over a 5-year period for patients with cervical arterial injuries due to penetrating craniofacial gunshot wounds who underwent CT angiography. Imaging results and clinical notes were reviewed. Results A total of 427 patients sustained gunshot wounds to the head, face and/or neck, of whom 222 underwent CT angiography yielding 56 patients with 78 vascular injuries. There were five internal carotid artery injuries remote from the wound tract. The incidence of these "indirect" cervical arterial injuries in our patient population was 1.2%, or 2.8% of patients who underwent CT angiography. Conclusions The incidence of "indirect" cervical arterial injuries with craniofacial gunshot wounds is comparable to or slightly higher than those seen in pure blunt trauma. Screening patients with craniofacial gunshot injuries with CTangiography may yield unexpected cervical vascular injuries remote from the penetrating tract. The significance and optimal therapy of these injuries are unknown. Additional experience will be needed to determine the significance of "indirect" cervical arterial injuries in the setting of craniofacial gunshot wounds. Key Points ̇ There are several known risk factors for blunt cervical arterial injuries. ̇ Cervical arterial injuries may occur remote from the wound following craniofacial gunshot wounds. ̇ Craniofacial gunshot wounds pose a risk for blunt cervical vascular injuries.

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