A blunt look at stroke risk in BCVI: Do multiple injuries increase the risk of stroke?

INTRODUCTION

Minimal literature correlates stroke rates in blunt cerebrovascular injury (BCVI) to bilaterality, multi-vessel injury, or multifocal injury. We hypothesized that a synchronous cerebrovascular injury and a higher-grade injury would increase stroke rates.

METHODS

A single-center retrospective (1/2016-12/2023) review was conducted identifying patients with BCVI. Injury characteristics, clinical features, and demographic data were collected and statistically modeled in relation to stroke risk.

RESULTS

Stroke rate in our cohort was 3.7 ​%. Higher-grade injuries increased the odds of stroke in carotid and vertebral BCVIs. The odds of stroke also increased with combined carotid and vertebral BCVIs versus isolated vertebral injury (OR 3.9 [1.4-10.2]), but not with bilateral carotid (OR 1.5 [0.5-3.9]) or vertebral injuries (OR 1.0 [0.3-2.8]).

CONCLUSION

Our findings support previous data on the relationship between BCVI grade and stroke risk; however, combined vertebral and carotid injuries may also increase the risk.