Episode 923: Blunt Cerebrovascular Injury

Episode 923: Blunt Cerebrovascular Injury

Contributor: Travis Barlock MD

Educational Pearls:

  • Assessment of head and neck vascular injury due to blunt trauma

    • Symptomatic patients require screening head and neck CT angiography

  • EAST guidelines include the following criteria for a screening CT angiography in blunt head trauma:

    • Unexplained neurological deficits

    • Arterial nosebleed

    • GCS < 6

    • Petrous bone fracture

    • Cervical spine fracture

    • Any size fracture through the transverse foramen

    • LeFort fractures type II or type III

  • EAST guidelines include a grading scale for vascular injury:

    • Grade I: Luminal irregularity or dissection with <25% luminal narrowing

    • Grade II: Dissection or intramural hematoma with >25% luminal narrowing, intraluminal thrombus, or raised intimal flap

    • Grade III: Pseudoaneurysm

    • Grade IV: Occlusion

    • Grade V: Transection with free extravasation

References

  1. Bensch FV, Varjonen EA, Pyhältö TT, Koskinen SK. Augmenting Denver criteria yields increased BCVI detection, with screening showing markedly increased risk for subsequent ischemic stroke. Emerg Radiol. 2019;26(4):365-372. doi:10.1007/s10140-019-01677-0

  2. Biffl WL, Moore EE, Offner PJ, et al. Optimizing screening for blunt cerebrovascular injuries. Am J Surg. 1999;178(6):517-522. doi:10.1016/s0002-9610(99)00245-7

  3. Kim DY, Biffl W, Bokhari F, et al. Evaluation and management of blunt cerebrovascular injury: A practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2020;88(6):875-887. doi:10.1097/TA.0000000000002668

Summarized & Edited by Jorge Chalit, OMS3

Donate: https://emergencymedicalminute.org/donate/

Jaksot(1145)

Podcast 890: Outdoor Cold Air for Croup

Podcast 890: Outdoor Cold Air for Croup

Contributor: Jared Scott MD Educational Pearls: Croup is a respiratory condition typically caused by a viral infection (e.g., parainfluenza). The disease is characterized by inflammation of the lary...

14 Helmi 20244min

Podcast 889: Blood Pressure Cuff Size

Podcast 889: Blood Pressure Cuff Size

Contributor: Aaron Lessen MD Educational Pearls: Does the size of a blood pressure (BP) cuff matter? A recent randomized crossover trial revealed that, indeed, cuff size can affect blood pressure read...

5 Helmi 20241min

Podcast 888: Low GCS and Intubation

Podcast 888: Low GCS and Intubation

Contributor: Aaron Lessen MD Educational Pearls: Is the adage, "GCS of 8, you've got to intubate" accurate? A recent study published in the November 2023 issue of JAMA attempted to answer this questio...

29 Tammi 20242min

Podcast 887: Family Presence in Cardiac Resuscitation

Podcast 887: Family Presence in Cardiac Resuscitation

Contributor: Aaron Lessen MD Educational Pearls: A 2013 study randomized families of those in cardiac arrest into two groups: Actively offered patients' families the opportunity to observe CPR ...

22 Tammi 20242min

Podcast 886: Cough in Kids

Podcast 886: Cough in Kids

Contributor: Ricky Dhaliwal, MD Educational Pearls: Croup Caused by: Parainfluenza, Adenovirus, RSV, Enterovirus (big right now) Age range: 6 months to 3 years Symptoms: Barky cough ...

15 Tammi 20246min

Podcast 885: Penetrating Neck Injuries

Podcast 885: Penetrating Neck Injuries

Contributor: Ricky Dhaliwal MD Educational Pearls: Three zones of the neck with different structures and risks for injuries: Zone 1 is the most caudal region from the clavicle to the cricoid cart...

10 Tammi 20244min

Laboring Under Pressure Episode 2: Postpartum Hemorrhage with Dr. Kiersten Williams

Laboring Under Pressure Episode 2: Postpartum Hemorrhage with Dr. Kiersten Williams

Contributor: Kiersten Williams MD, Travis Barlock MD, Jeffrey Olson MS2 Summary: In this episode, Dr. Travis Barlock and Jeffrey Olson meet in the studio to discuss a clip from Dr. Williams' talk at t...

8 Tammi 202425min

Podcast 884: Nerve Blocks

Podcast 884: Nerve Blocks

Contributor: Meghan Hurley MD Educational Pearls: What is a nerve block? A nerve block is the medical procedure of injecting anesthetic into the area around a nerve to block pain signals. They ar...

1 Tammi 20246min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
docemilia
utelias-mieli
radio-antro
filocast-filosofian-perusteet
rss-sosiopodi
ihanat-ipanat
mielipaivakirja
rss-bios-podcast
rss-duodecim-lehti
rss-laakaripodi
rss-radplus
rss-opeklubi
rss-lihavuudesta-podcast