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Blunt vertebral artery injury in occipital condyle fractures
- Source :
- Journal of Neurosurgery: Spine. 29:500-505
- Publication Year :
- 2018
- Publisher :
- Journal of Neurosurgery Publishing Group (JNSPG), 2018.
-
Abstract
- OBJECTIVEA shifting emphasis on efficient utilization of hospital resources has been seen in recent years. However, reduced screening for blunt vertebral artery injury (BVAI) may result in missed diagnoses if risk factors are not fully understood. The authors examined the records of blunt trauma patients with fractures near the craniocervical junction who underwent CTA at a single institution to better understand the risk of BVAI imposed by occipital condyle fractures (OCFs).METHODSThe authors began with a query of their prospectively collected trauma registry to identify patients who had been screened for BVAI using ICD-9-CM diagnostic codes. Grade and segment were recorded in instances of BVAI. Locations of fractures were classified into 3 groups: 1) OCFs, 2) C1 (atlas) fractures, and 3) fractures of the C2–6 vertebrae. Univariate and multivariate analyses were performed to identify any fracture types associated with BVAI.RESULTSDuring a 6-year period, 719 patients underwent head and neck CTA following blunt trauma. Of these patients, 147 (20%) had OCF. BVAI occurred in 2 of 43 patients with type I OCF, 1 of 42 with type II OCF, and in 9 of 62 with type III OCF (p = 0.12). Type III OCF was an independent risk factor for BVAI in multivariate modeling (OR 2.29 [95% CI 1.04–5.04]), as were fractures of C1–6 (OR 5.51 [95% CI 2.57–11.83]). Injury to the V4 segment was associated with type III OCF (p < 0.01).CONCLUSIONSIn this study, the authors found an association between type III OCF and BVAI. While further study may be necessary to elucidate the mechanism of injury in these cases, this association suggests that thorough cerebrovascular evaluation is warranted in patients with type III OCF.
- Subjects :
- Adult
Male
medicine.medical_specialty
Multivariate analysis
Vertebral artery
Wounds, Nonpenetrating
Neck Injuries
Young Adult
03 medical and health sciences
0302 clinical medicine
Blunt
medicine.artery
medicine
Humans
Vertebral Artery
Aged
Vertebral artery injury
Skull Fractures
business.industry
030208 emergency & critical care medicine
General Medicine
Middle Aged
Occipital condyle
Surgery
medicine.anatomical_structure
Blunt trauma
Occipital Bone
Mechanism of injury
Cervical Vertebrae
Female
Diagnosis code
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 15475654
- Volume :
- 29
- Database :
- OpenAIRE
- Journal :
- Journal of Neurosurgery: Spine
- Accession number :
- edsair.doi.dedup.....48654cef68ad9641817699346b105802