Head and neck neurovascular trauma: Clinical and angiographic correlation

• Published in: Interventional neuroradiology 2015-02, Vol.21 (1), p.108-113
• Main Authors: Ssenyonga, Peter Kato, Le Feuvre, David, Taylor, Allan
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Angiography; Blood Vessels - diagnostic imaging; Blood Vessels - injuries; Brain Injuries - diagnosis; Brain Injuries - diagnostic imaging; Female; Humans; Male; Middle Aged; Neck Injuries - diagnosis; Neck Injuries - diagnostic imaging; Retrospective Studies; Trauma; Young Adult
• ISSN: 1591-0199; 2385-2011
• DOI: 10.1177/1591019915576666

A retrospective review of all angiograms done for craniocervical trauma, over an eight-year period at Groote Schuur Hospital identified 61 patients out of 823 angiographically studied who had extradural vascular injury and required endovascular treatment. Multiple lesions were identified in nine (14,8%) patients and associated injuries were found in 23 patients (37%). The mechanism of injury was blunt in nine (14.8%) patients and penetrating in 52 (85.2%). There was a statistically significant correlation between the presenting clinical feature and the underlying angiographic lesion. Patients with active bleeding were more likely to have a vessel laceration, an expanding hematoma was associated with false aneurysm and a pulsatile mass with arteriovenous fistula. Endovascular treatment with emphasis on vessel occlusion rather than preservation was successful in all cases except one which required surgical vessel ligation.