AI Article Synopsis
- Traumatic internal carotid artery (ICA) injuries can occur due to petrous temporal bone (PTB) fractures and lead to severe outcomes like stroke or death; current screening guidelines for such injuries are inconsistently applied in clinical practice.
- A study analyzed 205 patients with PTB fractures who underwent CTA scans, finding a 9.4% rate of ICA injuries, with a significant in-hospital mortality rate primarily due to brain injury complications.
- Key factors linked to ICA injuries included fractures near the carotid canal, low initial Glasgow Coma Scale scores, higher head injury scores, and injuries from motor vehicle or motorbike accidents.
Article Abstract
Introduction: Traumatic internal carotid artery (ICA) injuries are an uncommon complication of petrous temporal bone (PTB) fractures that can have devastating consequences of stroke, haemorrhage and death. Current guidelines suggest that all PTB fractures should be screened for blunt cerebrovascular injury, however clinical practice varies. The purpose of this study was to identify features associated with PTB fractures that increase the likelihood of ICA injury.
Methods: A retrospective cohort study was performed on all patients with PTB fractures who were investigated with computed-tomography angiography (CTA) scan admitted to a Level One Trauma Service in Melbourne, Australia from 2015-2020. Patient demographic and injury data were obtained from The Royal Melbourne Hospital Trauma Registry and medical records. Multivariate binomial logistic regression was performed to identify features associated with ICA injury.
Results: Out of 377 patients with 419 PTB fractures, 205 received a CTA scan and were included, identifying 22 ICA injuries (9.4%). The median age of ICA injuries was 33 (IQR 23-61), median Abbreviated Injury Scale (AIS) score for the head region was 5 (IQR 5-5) and the in-hospital mortality rate was 45.5%, mainly due to unsurvivable brain injury. Five patients (22.7%) developed ICA-specific complications of stroke or carotid-cavernous fistula. We identified five factors that were significantly associated with ICA injury. These included PTB fractures involving the carotid canal (OR 6.7, 95% CI 1.9-23.9, p=0.003), presenting with an initial GCS less than nine (OR 5.7, 95% CI 1.2-26.5, p=0.025) and increasing head AIS (OR 2.4, 95% CI 1.2-4.6, p=0.009). Mechanisms of injury that were associated with ICA injury were motor vehicle crash (OR 4.4, 95% CI 1.4-14.2, p=0.012) and motorbike crash (OR 4.6, 95% CI 1.2-18, p=0.029).
Conclusion: Patients with PTB fractures and an additional feature of carotid canal involvement, presenting GCS less than nine, increasing head AIS indicative of severe head trauma or mechanism of injury by motor vehicle or motorbike crash, are at an increased risk of ICA injury and should be screened with a CTA scan.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.injury.2022.03.031 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Evaluation of a New Patellar Tendon Bearing Brace With Offloading Monitoring and Adjustability: A Pilot Study.
Health Sci Rep
December 2024
Background And Aims: The patellar tendon-bearing (PTB) brace is a crucial device designed to lessen axial forces on the tibia. The newly designed PTB brace allows clinicians to measure offloading amount in the realtime. This study aimed to explore the relationship between a rise in displacement between the foot plate and calf shells of this new PTB brace and changes in the amount of offloading on the tibia.
View Article and Find Full Text PDFA National Study of the Associations between Hormonal Modulators in Hydraulic Fracturing Fluid Chemicals and Birth Outcomes in the United States of America: A County-Level Analysis.
Environ Health Perspect
October 2024
Department of Mathematics, Saint Vincent College, Latrobe, Pennsylvania, USA.
Article Synopsis
- The study investigates the potential risks of preterm birth (PTB) and low birth weight (LBW) linked to hydraulic fracturing (HF) exposure, specifically looking at how chemicals in HF fluids affect hormone pathways like estrogen and testosterone.
- This is the first national analysis in the US to explore these associations and uses detailed statistical models to examine data from 2001 to 2018 across various counties.
- The research incorporates various factors such as demographics, education, agricultural practices, and health statistics to accurately assess the effects of HF well density and hormone-targeting chemicals on PTB and LBW rates.
Design and Evaluation of a Patellar Tendon-Bearing Brace with Off-Loading Mechanism on Tibia.
J Biomed Phys Eng
August 2024
Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
The current study aimed to design a patellar-tendon-bearing (PTB) brace capable of measuring and quantifying weight offloading on the tibia. The PTB brace was designed with off-loading mechanism on the tibia with features, including ankle joint, vertical sliding adaptor, vertical sliding piece, and upper connector of load cells to PTB brace. Also, the present study investigated the effect of brace on 20 healthy individuals under 8 different off-loading conditions, based on measuring the vertical distance between the calf shells and foot plate through a sliding adapter at 0.
View Article and Find Full Text PDFBackground: Distal radius fractures are the most common pediatric fractures, increasing in number in recent decades. Although simple bi-planar radiographs are sufficient for diagnosis, wrist ultrasonography has been popularized in recent years for fracture detection, mostly because of the concern about children's radiation exposure. Despite its availability and diagnostic accuracy, ultrasound has not gained widespread acceptance and popularity among orthopedic surgeons.
View Article and Find Full Text PDFFactors associated with blunt internal carotid artery injury in petrous temporal bone fractures.
Injury
June 2022
Department of General Surgical Specialities, The Royal Melbourne Hospital, Level 6 East, 300 Grattan Street, Melbourne, Victoria, 3050, Australia; Trauma Service, The Royal Melbourne Hospital, Level 6 East, 300 Grattan Street, Melbourne, Victoria, 3050, Australia; Department of Surgery, The University of Melbourne, Grattan Street, Parkville, Victoria, 3010, Australia; Australasian Trauma Society, PO Box 576, Crows Nest, New South Wales, 1585, Australia.
Article Synopsis
- Traumatic internal carotid artery (ICA) injuries can occur due to petrous temporal bone (PTB) fractures and lead to severe outcomes like stroke or death; current screening guidelines for such injuries are inconsistently applied in clinical practice.
- A study analyzed 205 patients with PTB fractures who underwent CTA scans, finding a 9.4% rate of ICA injuries, with a significant in-hospital mortality rate primarily due to brain injury complications.
- Key factors linked to ICA injuries included fractures near the carotid canal, low initial Glasgow Coma Scale scores, higher head injury scores, and injuries from motor vehicle or motorbike accidents.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!