Rozhledy v chirurgii : mesicnik Ceskoslovenske chirurgicke spolecnosti · 2018
Trauma of the extracranial cerebral arteries due to injuries of the cervical spine.
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Hajnovič Ľ, Šefránek V, Schütz L
Аннотация
INTRODUCTION: Cervical spine injuries are immanently accompanied by trauma to cerebral neck arteries.
METHOD: A prospective two-cohort study, from oct. 2013 to oct. 2015. Overall 76 Patients (39W/37M) of median age 77 years, with either fractures or discoligamentary injuries have been examined with duplex-sonography and or CT-angiography. From October 2013 to October 2017 we examined 155 Patients (49% female and 51% male), with the average age of 39 years, SD 19 and age median of 34 years, with cervical-spine-distortion, using the same diagnostic modalities. We used the statistics-program Bias 11.01.
RESULTS: The overall incidence of traumatic dissection of the internal carotid artery was 2.5%, in 50% of cases (1.2%) with neurological symptomato-logy. For the vertebral artery seems the incidence of 10.5%, with 25% of symptomatic patients (2.6%) comparably high. We have identified the osteophytes and dislocation as the significant risk factors. The canalis vertebralis and the skull-base are regions mostly prone to vascular injury. In the group of cervical spine distorsions we found no vascular trauma at all. The osteophytes were here identified as the main risk factor for collateral damage.
CONCLUSION: One should look for vascular injuries in case of cervical relevant spine trauma. Moreover, a rather relevant osteoligamentous injury should be assumed, when cervical vascular trauma was diagnosed. Key words: cervical spine trauma vessel-dissection duplex-sonography CT-angiography.
METHOD: A prospective two-cohort study, from oct. 2013 to oct. 2015. Overall 76 Patients (39W/37M) of median age 77 years, with either fractures or discoligamentary injuries have been examined with duplex-sonography and or CT-angiography. From October 2013 to October 2017 we examined 155 Patients (49% female and 51% male), with the average age of 39 years, SD 19 and age median of 34 years, with cervical-spine-distortion, using the same diagnostic modalities. We used the statistics-program Bias 11.01.
RESULTS: The overall incidence of traumatic dissection of the internal carotid artery was 2.5%, in 50% of cases (1.2%) with neurological symptomato-logy. For the vertebral artery seems the incidence of 10.5%, with 25% of symptomatic patients (2.6%) comparably high. We have identified the osteophytes and dislocation as the significant risk factors. The canalis vertebralis and the skull-base are regions mostly prone to vascular injury. In the group of cervical spine distorsions we found no vascular trauma at all. The osteophytes were here identified as the main risk factor for collateral damage.
CONCLUSION: One should look for vascular injuries in case of cervical relevant spine trauma. Moreover, a rather relevant osteoligamentous injury should be assumed, when cervical vascular trauma was diagnosed. Key words: cervical spine trauma vessel-dissection duplex-sonography CT-angiography.