Incidence of Blunt Cerebral Vascular Injury with Isolated Facial Fractures

Abstract

Blunt cerebral vascular injuries (BCVI) to the great vessels of the neck can be a significant cause of morbidity and mortality for patients. Identifying which populations of trauma patients merit screening for BCVIs when they have no BCVI symptoms is a controversial topic. There are traumatic mechanisms as well as signs and symptoms that have been documented as risk factors for BCVI. There are many situations where patients present with facial fractures and no obvious indications for BCVI screening; patients in these situations may still be screened if the provider has reasonable suspicion that a vascular injury may have occurred. Further evidence around blunt cerebral vascular injuries and their associated risk factors is needed to help providers decide which situations are appropriate to pursue BCVI screening. The purpose of this study was to determine the incidence of BCVI that occurs with isolated facial fractures in patients without accompanying acutely altered mental status, C-spine fracture, hematoma, or bruising of the neck, basilar skull fracture, or focal neurological deficits. These accompanying signs and symptoms were used as exclusion criteria.