Risk Of Vertebral Artery Injury And Stroke Following Blunt and Penetrating Cervical Spine Trauma: A Retrospective Review Of 729 Patients

Abstract Background Cervical spine trauma (CST) may result in Vertebral Artery Injury (VAI), increasing the risk of developing stroke. Stroke risk following CST is poorly reported. Methods 729 patients with CST were retrospectively analyzed, including rates of VAI, age at injury, cause of injury, cardiovascular history, smoking history, substance abuse history, embolization therapy, and antiplatelet or anticoagulant therapy prior or after injury. VAIs were identified and graded following the Modified Denver Criteria for Blunt Cerebrovascular Injury utilizing Magnetic Resonance Angiography and Computed Tomography Angiography (CTA). Brain scans were reviewed for stroke rates and statistically significant variations. Results 33 patients suffered penetrating trauma while 696 patients experienced blunt trauma. 81 patients met the criteria for analysis with confirmed VAI. VAI was more common in penetrating injury group compared to blunt injury group (64% vs 9%, P P P = 0.21). Cardiovascular comorbidities were significantly more common in the blunt group (50%, P = 0.0001) compared to penetrating group (0%). Conclusion VAI occurs with a high incidence in penetrating CST. Although stroke risk following penetrating and blunt CST did not vary significantly, they resulted in serious complications in a group of patients. Further studying of this patient population is required to provide high-level evidence-based preventions for VAI complications .