Munera Felipe, Foley Mark, Chokshi Falgun H
Radiology Department, Jackson Memorial Hospital, Ryder Trauma Center, University of Miami Miller School of Medicine, University of Miami Medical System, FL 33136, USA.
Radiol Clin North Am. 2012 Jan;50(1):59-72. doi: 10.1016/j.rcl.2011.08.007.
Blunt cerebrovascular injury (BCVI) is uncommon but potentially catastrophic; 80% are caused by vehicle collisions. Ischemic events secondary to untreated BCVI are common, with high injury-specific mortality. This has led to implementation of screening programs based on mechanism of injury, clinical presentation, and injury patterns identified on noncontrast computed tomography (CT) imaging. The standard of reference for diagnosis is four-vessel digital subtraction angiography. Given its availably in trauma service institutions, use of multidetector CT angiography has increased. This article presents the evidence and the controversies surrounding its use. Available protocols, injury description, and grading, as well as potential pitfalls are reviewed.
钝性脑血管损伤（BCVI）并不常见，但可能具有灾难性后果；80%由车辆碰撞引起。未经治疗的BCVI继发的缺血性事件很常见，具有很高的损伤特异性死亡率。这导致了基于损伤机制、临床表现和非增强计算机断层扫描（CT）成像确定的损伤模式实施筛查计划。诊断的参考标准是四血管数字减影血管造影。鉴于其在创伤服务机构中的可用性，多排CT血管造影的使用有所增加。本文介绍了围绕其使用的证据和争议。对可用的方案、损伤描述和分级以及潜在的陷阱进行了综述。
