Associate Professor, Interim Division Chief, Neurocritical Care, Departments of Neurology and Emergency Medicine, University of North Carolina School of Medicine, Chapel Hill, NC.
Emerg Med Pract. 2020 Dec 15;22(Suppl 12):1-43.
Blunt cerebrovascular injuries include cervical carotid dissections and vertebral artery dissections that are due to blunt trauma. Although the overall incidence is low, dissections remain a common cause of stroke in children, young adults, and trauma patients. Symptoms of dissection, such as headache, neck pain, and dizziness, are commonly seen in the emergency department, but may not be apparent in the obtunded trauma patient or may not be recognized as being due to a dissection. A missed diagnosis of cervical artery dissection can result in devastating neurologic sequelae, and emergency clinicians must act quickly to recognize this diagnosis and begin treatment as soon as possible. This supplement reviews the application of advanced screening criteria, imaging options, and antithrombotic treatment for patients with blunt cerebrovascular injuries, with a focus on reducing the occurrence of ischemic stroke.
钝性脑血管损伤包括因钝性创伤引起的颈内颈动脉夹层和椎动脉夹层。尽管总体发生率较低，但夹层仍然是儿童、年轻成人和创伤患者中风的常见原因。夹层的症状，如头痛、颈部疼痛和头晕，在急诊科很常见，但在昏迷的创伤患者中可能不明显，也可能不被认为是夹层引起的。颈内动脉夹层的漏诊可导致严重的神经后遗症，因此急诊临床医生必须迅速采取行动，识别这一诊断，并尽快开始治疗。本增刊综述了应用先进的筛查标准、影像学选择和抗血栓治疗钝性脑血管损伤患者的方法，重点是减少缺血性中风的发生。
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