Blunt carotid and vertebral artery injuries

Injury. 2008 Nov;39(11):1232-41. doi: 10.1016/j.injury.2008.02.042. Epub 2008 Sep 3.


The recognition and treatment of blunt cerebrovascular injuries has dramatically evolved over the past two decades. As imaging technology has improved both with respect to the image quality and acquisition times, its use has become a fundamental diagnostic tool in blunt trauma evaluation. The single greatest radiological advance in the past quarter century has been the refinement and increasing use of computed tomographic imaging for the diagnosis of surgical disease. Paralleling advances in noninvasive imaging, a heightened awareness of blunt cerebrovascular injuries has emerged, and the first screening protocols were developed at high volume trauma centres. Through aggressive screening, these injuries have increasingly been recognised before devastating neurological ischaemia and adverse neurocognitive outcomes. The mainstay of treatment for these injuries is antithrombotic therapy. However, all blunt cerebrovascular injuries require short and long-term follow-up. While the majority of injuries will resolve with medical management, a proportion will require further intervention in order to reduce the risk of subsequent stroke.

Publication types

  • Review

MeSH terms

  • Angiography, Digital Subtraction / methods
  • Carotid Artery Injuries* / diagnostic imaging
  • Carotid Artery Injuries* / etiology
  • Carotid Artery Injuries* / therapy
  • Female
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Injury Severity Score
  • Male
  • Nervous System Diseases / prevention & control
  • Stroke / etiology
  • Stroke / prevention & control
  • Vertebral Artery / diagnostic imaging
  • Vertebral Artery / injuries*
  • Wounds, Nonpenetrating* / diagnostic imaging
  • Wounds, Nonpenetrating* / etiology
  • Wounds, Nonpenetrating* / therapy


  • Fibrinolytic Agents