Journal Review in Trauma Surgery: Imaging for Blunt Cerebrovascular Injury (BCVI)

Behind The Knife: The Surgery Podcast

Science, Health & Fitness, Medicine, Education

4.8 • 1.4K Ratings

🗓️ 2 June 2022

⏱️ 27 minutes

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Summary

Determining when to order imaging for blunt cerebrovascular injury is a diagnostic quandary that has long engendered controversy. Today we discuss a paper that introduced universal CT angiogram of the neck to screen for BCVI in all blunt trauma patients and then compared the result to what would have happened if some of the current screening guidelines were utilized. Join us as we discuss their fascinating results and what it means for blunt trauma patients going forward.

Hosts:
Elliott R. Haut, MD, Ph.D., a senior, nationally recognized name in trauma and acute care surgery at Johns Hopkins University. Dr. Haut is a past president of The Eastern Association for the Surgery of Trauma (EAST).
Marcie Feinman, MD, MEHP, the current program director of General Surgery Residency at Sinai Hospital of Baltimore and editorial board member of SCORE. She received her Master's in Education in the Health Professions from Johns Hopkins.
David Sigmon, MD, MMEd, a PGY-6 resident at the University of Illinois at Chicago who plans on going into trauma surgery. He did two years of research in surgical education at the University of Pennsylvania where he also received his Master’s in Medical Education.

LITERATURE

Black JA, Abraham PJ, Abraham MN, et al. Universal screening for blunt cerebrovascular injury. J Trauma Acute Care Surg. 2021;90(2):224-231.
https://pubmed.ncbi.nlm.nih.gov/33502144/
Kim DY, Biffl W, Bokhari F, et al. Evaluation and management of blunt cerebrovascular injury: A practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2020;88(6):875-887. https://pubmed.ncbi.nlm.nih.gov/32176167/
Biffl WL, Moore EE, Offner PJ, Brega KE, Franciose RJ, Elliott JP, Burch JM. Optimizing screening for blunt cerebrovascular injuries. (1999) American journal of surgery. 178 (6): 517-22.
https://pubmed.ncbi.nlm.nih.gov/10670864/
Geddes AE, Burlew CC, Wagenaar AE, Biffl WL, Johnson JL, Pieracci FM, Campion EM, Moore EE. Expanded screening criteria for blunt cerebrovascular injury: a bigger impact than anticipated. (2016) American journal of surgery. 212 (6): 1167-1174. https://pubmed.ncbi.nlm.nih.gov/27751528/
Ciapetti M, Circelli A, Zagli G et-al. Diagnosis of carotid arterial injury in major trauma using a modification of Memphis criteria. Scand J Trauma Resusc Emerg Med. 2010;18 (1): 61.
https://pubmed.ncbi.nlm.nih.gov/21092211/

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Transcript

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0:00.0	When you can't quite get the angle, take hands-free selfies with the Samsung Galaxy Z Flip 5,
0:05.2	stand it up, step back, and your photos are also synced to your Chromebook, ready to edit.
0:10.8	The new Samsung Galaxy Z Flip 5 and Chromebook, available on Vodafone.
0:20.9	Behind the night, the surgery podcast, relevant and engaging content designed to help you
0:27.0	dominate the day.
0:37.1	Welcome to Behind the Knife Trauma Edition. This is our team's fourth podcast,
0:41.8	and we are excited to continue to share our expertise and trauma with you.
0:46.2	My name is Dr. Marcy Feiman, and I am a trauma and acute care surgeon in Baltimore, Maryland,
0:51.1	as well as the general surgery residency program director at Sinai Hospital.
0:55.4	I am joined by Dr. David Sigmund, PGY4 at University of Illinois at Chicago,
1:00.3	and Education Guru, as well as Dr. Elliott Hout, trauma surgeon extraordinaire from Johns Hopkins
1:06.1	and past president of the Eastern Association for the Surgery of Trauma. Together, we will be your
1:11.3	hosts in this episode, as we discuss the article titled Universal Screening for Blunt's
1:17.2	Serubovascular Injury, written by a multidisciplinary group led by Dr. Jonathan Black at the University
1:23.7	of Alabama at Birmingham. Before we really get into the article, though, David, why don't you tell us
1:29.3	a little bit about how we got to the point of even needing Blunt's Serubovascular Injury Screening?
1:36.4	So actually, before I talk about imaging, you know, I'm a big history buff, so I look into the
1:40.5	history of Blunt's Serubovascular Injury for this paper. And it's actually interesting. Blunt's
1:45.2	Serubovascular Injury is actually in the name of the carotids themselves. The word carotid is derived
1:50.7	from the Greek word caros, meaning to stun or place in a deep sleep. While Hippocrates is
1:56.5	initially credited with using this word to describe the arteries, eventually it was Rufus
2:00.8	Vefesius, a first-century physician, who was referenced by none other than Galen, who was the
	...

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