{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:27:38Z","timestamp":1787063258917,"version":"build-2736575974"},"reference-count":17,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2010,5]]},"abstract":"\n Object<\/jats:title>\n Blunt cerebrovascular injury (BCI) to the carotid and vertebral arteries is being recognized with increasing frequency in trauma victims. Yet, only broadly defined criteria exist for the use of screening angiography. In this study, the authors systematically identified the associated injuries that predict BCI and provide guidelines for the types of injuries best evaluated by angiography.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Criteria for screening angiography were developed with intentionally broad inclusion to maximize sensitivity. Screening criteria for each patient and angiographic results (5-point scale of BCI) were recorded prospectively. Injuries most often associated with a positive angiogram were identified. Dissection grades of 0\u20131 were classified as minor.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 365 patients evaluated for trauma by angiography between January 2000 and December 2005, 40 patients with penetrating trauma were excluded. Of the 325 patients included in the study, 100 (30.8%) had positive angiographic findings, including 79 (24.3%) with major injuries. Fractures of the cervical spine and midface (or mandibular ramus) were associated with major BCI (identified in 30.7% of patients with cervical fractures and 30.8% of patients with midface fractures). However, thoracic trauma and soft tissue injury of the neck were rarely associated with a significant BCI (0 and 3 cases, respectively). Horner syndrome and cervical bruit were associated with arterial dissection in 9 of 10 patients. Skull base fractures and unexplained neurological findings were associated with major BCI in 13 (18.3%) of 71 and 11 (16.9%) of 65 patients, respectively.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Cervical and facial fractures resulting from blunt trauma were highly associated with BCI. After significant thoracic trauma or soft tissue injury to the neck, angiography should be reserved for patients with unexplained neurological findings or expanding hematomas of the neck.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2009.6.jns08416","type":"journal-article","created":{"date-parts":[[2009,7,31]],"date-time":"2009-07-31T09:00:45Z","timestamp":1249030845000},"page":"1146-1149","source":"Crossref","is-referenced-by-count":18,"title":["Screening for blunt cerebrovascular injury: selection criteria for use of angiography"],"prefix":"10.3171","volume":"112","author":[{"given":"Andrew J.","family":"Ringer","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati Neuroscience Institute and University of Cincinnati College of Medicine;"},{"name":"Mayfield Clinic; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Matern","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Hospital, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Parikh","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati Neuroscience Institute and University of Cincinnati College of Medicine;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas B.","family":"Levine","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati Neuroscience Institute and University of Cincinnati College of Medicine;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-1121146","series-title":"J Trauma","first-page":"745","article-title":"Sixteenslice computed tomographic angiography is a reliable noninvasive screening test for clinically significant blunt cerebrovascular injuries","volume":"60","author":"Biffl","year":"2006"},{"key":"b2-1121146","series-title":"Ann Surg","first-page":"672","article-title":"The devastating potential of blunt vertebral artery injuries","volume":"231","author":"Biffl","year":"2000"},{"key":"b3-1121146","series-title":"J Trauma","first-page":"845","article-title":"Blunt carotid arterial injuries: implications of a new grading scale","volume":"47","author":"Biffl","year":"1999"},{"key":"b4-1121146","series-title":"Am J Surg","first-page":"517","article-title":"Optimizing screening for blunt cerebrovascular injuries","volume":"178","author":"Biffl","year":"1999"},{"key":"b5-1121146","series-title":"Ann Surg","first-page":"462","article-title":"The unrecognized epidemic of blunt carotid arterial injuries: early diagnosis improves neurologic outcome","volume":"228","author":"Biffl","year":"1998"},{"key":"b6-1121146","series-title":"J Trauma","first-page":"473","article-title":"The spectrum of blunt injury to the carotid artery: a multicenter perspective","volume":"37","author":"Cogbill","year":"1994"},{"key":"b7-1121146","series-title":"Youman's Neurological Surgery","first-page":"5203","article-title":"Traumatic cerebrovascular injury","author":"Elliott","year":"2004"},{"key":"b8-1121146","series-title":"Ann Surg","first-page":"513","article-title":"Blunt carotid injury: importance of early diagnosis and anticoagulant therapy","volume":"223","author":"Fabian","year":"1996"},{"key":"b9-1121146","series-title":"Neurol Clin","first-page":"155","article-title":"Dissections of the cervical and cerebral arteries","volume":"1","author":"Hart","year":"1983"},{"key":"b10-1121146","series-title":"J Neurol Neurosurg Psychiatry","first-page":"863","article-title":"Dissection of the extracranial vertebral artery: report of four cases and review of the literature","volume":"54","author":"Hinse","year":"1991"},{"key":"b11-1121146","series-title":"J Neurol","first-page":"327","article-title":"Extracranial vertebral artery dissection: nine cases","volume":"239","author":"Josien","year":"1992"},{"key":"b12-1121146","series-title":"J Am Coll Surg","first-page":"80","article-title":"Blunt carotid injury","volume":"185","author":"Parikh","year":"1997"},{"key":"b13-1121146","series-title":"N Engl J Med","first-page":"898","article-title":"Spontaneous dissection of carotid and vertebral arteries","volume":"344","author":"Schievink","year":"2001"},{"key":"b14-1121146","series-title":"Bull Acad Natl Med (Paris)","first-page":"46","article-title":"Contusions multiples; d\u00e9lire violent; h\u00e9mipl\u00e9gie \u00e0 droite, signes de compression c\u00e9r\u00e9brale","volume":"36","author":"Verneuil","year":"1872"},{"key":"b15-1121146","series-title":"J Trauma","first-page":"1221","article-title":"Management of blunt injury to the internal carotid artery","volume":"27","author":"Welling","year":"1987"},{"key":"b16-1121146","series-title":"Neurosurgery","first-page":"435","article-title":"The incidence of vertebral artery injury after midcervical spine fracture or subluxation","volume":"34","author":"Willis","year":"1994"},{"key":"b17-1121146","series-title":"Arch Surg","first-page":"425","article-title":"Extracranial internal carotid artery dissections: noniatrogenic traumatic lesions","volume":"117","author":"Zelenock","year":"1982"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/112\/5\/article-p1146.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/112\/5\/article-p1146.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/112\/5\/article-p1146.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T03:33:44Z","timestamp":1679888024000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/112\/5\/article-p1146.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2010,5]]},"references-count":17,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2009.6.jns08416","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,5]]}}}