Blunt cerebrovascular injury
Blunt injury to the neck resulting in an intimal tear in the carotid or vertebral artery
Anatomy/pathophysiology
[edit | edit source]- Mostly occurs in ICA below the petrous part of the temporal bone
- Can lead to stenosis, occlusion, pseudoaneurysm or embolisation
- Most commonly occurs with a cervical hyperflexion/hyperextension injury
Grading
[edit | edit source]- Grade I: luminal irregularity or dissection with <25% narrowing
- Grade II: dissection or intra-luminal haematoma with 25% or greater luminal narrowing, intraluminal thrombus, or raised intimal flap
- Grade III: pseudoaneurysm
- Grade IV: occlusion
- Grade V: transection with free extravasation
Management
[edit | edit source]- Anticoagulation or antiplatelets
- Endovascular intervention for grade III or V