Computed Tomography Predictors of Vascular Injury in Cranioencephalic Trauma Patients

Abstract

Objective A frequent challenge for the neurosurgeon when treating a patient with cranioencephalic trauma is to determine whether the patient has a vascular lesion, when to suspect it, and what studies to request. In this context, the objective of the present study was to identify the variables on cranial computed tomography (CT) scans that predict vascular injury in digital subtraction angiography in patients with cranioencephalic trauma.

Methods We conducted a cross-sectional study of patients with cranioencephalic trauma admitted to the Hospital Universitario del Valle between June 2016 and June 2019. Subjects with available simple CT images of the skull and digital subtraction angiography were included.

Results A total of 138 subjects who met the inclusion criteria were identified. The average age was 32 years, 82% were men, and the most frequent mechanism of injury was firearm wound (59%). The variables associated with vascular injury were fracture of the base of the temporal skull and sphenoid fracture.

Conclusion The presence of fractures of the base of the temporal skull and sphenoid fractures is associated with vascular injury in patients with cranioencephalic trauma.

Resumo

Objetivo Um desafio frequente para o neurocirurgião no cuidado de um paciente com traumatismo crânio-encefálico é determinar se o paciente tem lesão vascular, quando suspeitar que tem, e quais estudos pedir. Neste contexto, o objetivo deste estudo foi identificar as variáveis da tomografia computadorizada (TC) de crânio que predizem lesão vascular na angiografia por subtração digital em pacientes com traumatismo crânio-encefálico.

Métodos Fez-se um estudo transversal de pacientes com traumatismo crânio-encefálico internados no hospital (cego) entre junho de 2016 e junho de 2019. Foram incluídos também pacientes com imagens de TC simples do crânio e angiografia de subtração digital disponíveis.

Resultados Foram identificados um total de 138 sujeitos que cumpriam os critérios de inclusão. A média de idade foi de 32 anos, 82% eram homens, e o mecanismo da lesão mais frequente foi o ferimento por arma de fogo (59%). As variáveis associadas à lesão vascular foram a fratura da base do crânio temporal e a fratura esfenoidal.

Conclusão A presença de fraturas da base do crânio temporal e fraturas do esfenoide está associada à lesão vascular em pacientes com traumatismo crânio-encefálico.

Keywords

traumatic brain injuries - vascular system injuries - X-ray computed tomography

Palavras-chave

lesões encefálicas traumáticas - lesões do sistema vascular - tomografia computadorizada por raios X

Informed Consent and Patient Details

The authors declare that this report does not contain any personal information that could lead to the identification of the patient(s) and/or volunteers.

Author Contributions

All authors attest that they meet the current International Committee of Medical Journal Editors (ICMJE) criteria for authorship.

Publikationsverlauf

Eingereicht: 19. April 2021

Angenommen: 30. Juli 2021

Artikel online veröffentlicht:
20. Juli 2022

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