Difference between revisions of "Blunt neck trauma"

(Evaluation)
(Evaluation)
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==Evaluation==
 
==Evaluation==
 
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===General Approach===
{{C-spine NEXUS}}
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*If concern for cervical spine injury, use a [[cervical spine clearance]] decision rule to determine need for imaging
:^If find injury consider CT C-spine, x-ray rest of spine
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*Perform a neuro exam, to determine concern for [[spinal cord injury]]
 
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*If concern for vascular injury, use the [[Denver screening criteria]]
===[[Spinal cord trauma]]===
 
*Neuro exam
 
 
 
{{Denver Screening Criteria}}
 
  
 
===Pediatrics===
 
===Pediatrics===

Revision as of 12:47, 22 February 2020

Background

  • Suspect vascular damage to cord, if discrepancy between neuro deficit and level of spinal column injury
  • Spinal cord injury is more likely if anterior (vertebral bodies) AND posterior (spinal canal) columns are disrupted

Clinical Features

  • Signs of life-threatening neck or upper thoracic injury (look for TWELVE):
Tracheal deviation,
Wounds,
External markings,
Laryngeal disruption,
Venous distention,
Emphysema (surgical)

Differential Diagnosis

Neck Trauma

Other

Evaluation

General Approach

Pediatrics

  • In a small study of 42 patients with a cervical seatbelt sign there were no isolated cerebrovascular injuries. For pediatric patients in a motor vehicle collision, the presence of an isolated seatbelt sign was not associated with any cases of cerebrovascular injury. [1]

Management

Disposition

  • Based on specific diagnosis

See Also

External Links

References

  1. Desai NK, et al. Screening CT angiography for pediatric blunt cerebrovascular injury with emphasis on the cervical “seat- belt sign.” AJNR Am J Neuroradiol. 2014 Sep;35(9):1836-40. PMID: 24722311.