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CT Scans Help Detect Blunt Injury in Trauma Patients

By MedImaging International staff writers
Posted on 10 Feb 2017

Image: New research asserts that CT scans can help detect blunt injury in trauma patients (Photo courtesy of GE Healthcare).

Advances in diagnostic imaging technology over the past 30 years have led to a six-fold increase in blunt cerebrovascular injury (BCVI) detection rates, according to a new study.

Researchers at the University of Tennessee Health Science Center conducted a study to identify patients with BCVI between 1985 and 2015, who were then stratified by age, gender, and injury severity score (ISS). In all, 564 patients (65% male, mean age 41) were diagnosed with BCVI; 508 with carotid artery and 267 with vertebral artery injuries. BCVI-related stroke and mortality rates were then calculated, and the patients were divided into five eras based on changes in technology, screening, or treatment algorithms.

The results showed that the percentage of blunt trauma patients diagnosed with BCVI increased from 0.33% to 2% during the study period. However, the percentage of these patients who went on to have a stroke due to the injury declined from 37% to 5% over the same period, and those who died from BCVI declined from 24% to zero. The researchers attribute these results to CT-scanning and its availability in hospitals large and small. The study was published on January 19, 2017, in the Journal of the American College of Surgeons (JACS).

“Clearly the advances in CT-scanning technology that developed since the first CT scanners came out to being able to do CT angiography, which is really a noninvasive form of angiography, have significantly improved diagnosis,” said lead author Louis Magnotti, MD, of the UTHSC department of surgery. “It is important to not get bogged down in managing or treating or diagnosing patients the same way as times change. Even though you may have had good results, you should always look to do better.”

“Not every hospital is going to have access to digital subtraction angiography, which needs to be performed by an interventional radiologist or vascular surgeon or neuro-interventionist, but the majority of hospitals, even small hospitals, have CT-scanning ability,” concluded Dr. Magnotti. “They can diagnose these injuries on the front end, and even if they cannot treat them, they can at least refer these patients to centers that can treat them.”

BCVI is primarily caused by longitudinal stretching and injury to the carotid or vertebral vessels. Motor vehicle accidents (MVA) resulting in acceleration-deceleration can cause rotation and hyperextension of the neck, stressing the craniocervical vessels, the mechanism for the most common cause of BCVI. A direct blow to the neck or base of the skull may injury the carotid or vertebral arteries. BCVI is diagnosed in approximately 0.1% of patients hospitalized for trauma in the United States, unless a screening program has been initiated. Most cases are diagnosed following development of symptoms secondary to central nervous system ischemia, with a resultant neurologic morbidity of up to 80% and associated mortality of up to 40%.

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62 (540.01808166504): SELECT fid FROM jos_deeppockets WHERE id=294768110 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294768110 AND published='1' LIMIT 1

63 (334.9781036377): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=215 ORDER BY `ordering`

64 (60.081481933594): select jos_twitters.link from jos_twitters where cat=10

65 (29.087066650391): select jos_facebook.link from jos_facebook where cat=10

66 (30.040740966797): select jos_google_plus.link from jos_google_plus where cat=10

67 (28.133392333984): select jos_linkedin.link from jos_linkedin where cat=10

68 (30.994415283203): SELECT fid FROM jos_deeppockets WHERE id=294768110 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294768110 AND published='1' LIMIT 1

69 (30.994415283203): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=215 ORDER BY `ordering`

70 (252.00843811035): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294768110 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (211.95411682129): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294768110 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (44.107437133789): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (67.949295043945): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (59.127807617188): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (37.193298339844): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (60.081481933594): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294768110 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (31.948089599609): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294768110 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (37.193298339844): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (64.849853515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294768110 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294768110 AND published='1' LIMIT 1

105 (53.167343139648): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294768110 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294768110 AND published='1' LIMIT 1

106 (74.863433837891): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294768110 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (57.93571472168): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294768110 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294768110 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294768110 AND published='1' LIMIT 1

109 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294768110 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294768110 AND published='1' LIMIT 1

110 (47.206878662109): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294768110 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (474.92980957031): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294768110 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (573.87351989746): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (335.9317779541): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294768110 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294768110 AND published='1' LIMIT 1

115 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294768110 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294768110 AND published='1' LIMIT 1

116 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294768110 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294768110 AND published='1' LIMIT 1

117 (36.954879760742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294768110 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294768110 AND published='1' LIMIT 1

118 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294768110 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294768110 AND published='1' LIMIT 1

119 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294768110 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294768110 AND published='1' LIMIT 1

120 (74.148178100586): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294768110 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294768110 AND published='1' LIMIT 1

121 (40.054321289062): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294768110 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294768110 AND published='1' LIMIT 1

122 (444.17381286621): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294768110 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294768110 AND type='deeppockets_item' AND published='1' LIMIT 1

123 (!!!!! 7632.0171356201): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

124 (82.969665527344): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

125 (283.95652770996): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

126 (73.909759521484): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

127 (207.18574523926): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

128 (32.901763916016): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

129 (179.05235290527): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

130 (32.901763916016): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

131 (173.80714416504): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

132 (31.948089599609): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

133 (458.95576477051): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294768110 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (340.93856811523): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294768110 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (194.07272338867): SELECT name FROM jos_deeppockets WHERE id=215

136 (31.948089599609): SELECT name FROM jos_deeppockets WHERE id=215

137 (530.00450134277): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (432.96813964844): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (63.180923461914): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294768110 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294768110 AND published='1' LIMIT 1

140 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294768110 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294768110 AND published='1' LIMIT 1

141 (283.00285339355): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294768110 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

142 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294768110 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

143 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294768110 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294768110 AND published='1' LIMIT 1

144 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294768110 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294768110 AND published='1' LIMIT 1

145 (!!!!! 1373.0525970459): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

146 (73.909759521484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294768110 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294768110 AND published='1' LIMIT 1

147 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294768110 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294768110 AND published='1' LIMIT 1

148 (55.074691772461): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294768110 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294768110 AND type='deeppockets_item' AND published='1' LIMIT 1

149 (42.915344238281): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

150 (39.815902709961): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

151 (51.021575927734): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

152 (100.85105895996): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294768110 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294768110 AND published='1' LIMIT 1

153 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294768110 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294768110 AND published='1' LIMIT 1

154 (45.061111450195): select jos_twitters.link from jos_twitters where cat=10

155 (29.087066650391): select jos_facebook.link from jos_facebook where cat=10

156 (28.848648071289): select jos_google_plus.link from jos_google_plus where cat=10

157 (29.087066650391): select jos_linkedin.link from jos_linkedin where cat=10

158 (251.05476379395): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14202,14203)

159 (!!!!! 1061.9163513184): insert into jos_banners_delta values (14202,'2025-06-22 05:32:45','216.73.216.120','view'),(14203,'2025-06-22 05:32:45','216.73.216.120','view')

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