Blunt neck trauma: Difference between revisions

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== Vascular Injuries ==
== Vascular Injuries ==
*Carotid and vertebral artery injuries can occur with blunt c-spine trauma
*[[Vertebral and Carotid Artery Dissection]]
**Half of patients present with initially normal neuro exam
**OR for carotid/vertebral artery injury of 8.6 with c-spine fracture
**OR for vertebral artery injury of 30.6 with transverse process fracture
**Vertebral angiography for transverse process fractures extending into transverse foramen or evidence of vertebral-basilar insufficiency(90% show dissection or occlusion of vertebral artery)
*Indications for screening (CTA or MRA) for vascular injury
**Unexplained neuro deficit with hyperflexion or extension injury
**Blunt trauma to neck or seatbelt injury
**C-spine or skull base fractures involving vascular foramina
**[[Le Fort]] II or III facial fractures


==Workup==
==Workup==

Revision as of 07:53, 27 January 2015

Background

Three column concept of spinal fracture stability
  • Suspect vascular damage to cord if discrepancy between neuro deficit and level of spinal column injury
  • Cord injury is more likely if anterior (vertebral bodies) AND posterior (spinal canal) columns are disrupted
  • Penetrating injury rarely results in unstable fracture

Fractures and Related

Vertebral fractures and dislocations types

Vertebral anatomy.
Numbering order of vertebrae.

Vascular Injuries

Workup

  • If find injury consider CT C-spine, x-ray rest of spine

Management

See Also

Source

  • National Spinal Cord Injury Statistical Center (NSCISC). Spinal Cord Injury. Facts and Figures at a Glance. Birmingham, Ala: NSCISC; July 1996
  • Ivy ME, Cohn SM. Addressing the myths of cervical spine injury management. Am J Emerg Med. Oct 1997;15(6):591-5
  • Woodring JH, Lee C, Duncan V. Transverse process fractures of the cervical vertebrae: are they insignificant? J Trauma. June 1993; 34(6):797-802.
  • Tintinalli's