gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Whole body trauma CT imaging with adapted CT angiography of the cranio-cervical vessels: incidence of associated vessel injury

Polytrauma-CT mit adaptierter CT-Angiographie der kranio-zervikalen Gefäße: Inzidenz assoziierter Gefäßverletzungen

Meeting Abstract

  • corresponding author S. Fleck - Klinik und Poliklinik für Neurochirurgie, Ernst-Moritz-Arndt-Universität Greifswald
  • S. Langner - Institut für Diagnostische Radiologie und Neuroradiologie, Ernst-Moritz-Arndt-Universität Greifswald
  • J. Baldauf - Klinik und Poliklinik für Neurochirurgie, Ernst-Moritz-Arndt-Universität Greifswald
  • M. Kirsch - Institut für Diagnostische Radiologie und Neuroradiologie, Ernst-Moritz-Arndt-Universität Greifswald
  • H. W. S. Schroeder - Klinik und Poliklinik für Neurochirurgie, Ernst-Moritz-Arndt-Universität Greifswald

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocFR.02.07

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2007/07dgnc072.shtml

Veröffentlicht: 11. April 2007

© 2007 Fleck et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: The incidence of traumatic craniocervical artery dissection varies in published trauma series and is associated with cervical spine trauma. The purpose of this study was to determine the incidence of traumatic craniocervical artery injury in polytraumatized patients by using a standardized whole body trauma CT with an adapted CT angiography (CTA) of the craniocervical vessels.

Methods: 204 patients requiring a whole body trauma CT due to the mechanism of their injury were analyzed retrospectively. All examinations were performed using a 16 row MSCT (Sensation 16, Siemens, Erlangen) in the last 9 months. Initially a spiral scan of the neurocranium angulated in an orbito-mental orientation was acquired. Then a CT angiography of the craniocervical vessels with 40 ml of iodinated contrast agent (flow 4ml/s; 40 ml saline flush, flow 4ml/s) was performed,starting at the level of C6 up to the roof of the lateral ventricles (100kV, 120mAs, collimation 16x0.75). The scan was started using bolus tracking. Finally, a contrast-enhanced spiral thoraco-abdominal scan was performed with a delay of 20 sec after administering a second contrast bolus of 60 ml. The craniocervical vessels were analyzed in the source images and using 20mm thin slice MIP-reconstructions.

Results: CTA was diagnostic in all patients. Isolated cervical spine injuries were observed in 11 patients (5,4%), isolated cranial injuries in 59 patients (28,9%) whereas combined cervical and cranial lesions were seen in 5 patients (2,45%). Injuries of craniocervical vessels were observed in 2 cases or skull base fractures.

Conclusions: Craniocervical vessel injury is a rare (0,98%) (1 vertebral artery dissection and 1 carotid dissection combined with carotid cavernous fistula) in isolated cervical event occurring in cases of high velocity injury. Whole body trauma CT scan with an adapted scanning protocol for the craniocervical vessels is a fast, safe and feasible method for detecting vascular injuries in the craniocervical region. It allows prompt further treatment if necessary.