N. Hernandez1, A. Elkbuli1 1Orlando Regional Medical Center, Trauma Surgery, Orlando, FL, USA
Introduction: This study aims to evaluate the incidence, risk factors, and clinical outcomes among adult trauma patients with isolated blunt cerebrovascular injuries (BCVIs) with and without traumatic brain injury (TBI).
Methods: This retrospective cohort analysis of the ACS-TQIP database (2017-2021) evaluated outcomes among BCVI patients with and without TBI, by intervention type (operative vs. non-operative), and BCVI injury grade.
Results: Of 2,172 patients with isolated BCVI, 1,262 (58.1%) had carotid artery injuries and 910 (41.9%) had vertebral artery injuries. Among non-TBI patients, BCVI was significantly associated with cervical spine fractures (OR 11.598, 95% CI 10.282-13.082, p<0.001), mandibular fractures (OR 2.866, 95% CI 2.110-3.892, p<0.001), GCS ≤8 (OR 1.649, 95% CI 1.219-2.230, p=0.001), and ischemic stroke (OR 19.316, 95% CI 4.706-79.279, p<0.001). Among TBI patients, BCVI was significantly associated with cervical spine fractures (OR 6.790, 95% CI 5.493-8.393, p<0.001), mandibular fractures (OR 2.098, 95% CI 1.370-3.213, p<0.001), and ischemic stroke (OR 40.666, 95% CI 9.398-175.969, p<0.001).
Conclusion: Patients with BCVI had significantly higher odds of presenting with cervical spine and mandibular fractures and developing ischemic stroke compared to those without BCVI. Understanding the risk factors for BCVI can help guide further investigations and support prompt diagnosis, optimizing care and improving patient outcomes.