Blunt carotid and vertebral artery injuries in multiply traumatized patients – Two different entities?

Introduction: Blunt Cerebrovascular injuries (BCVI) represent a significant risk factor for morbidity and mortality in patients, especially after high-energy trauma.Vertebral and carotid artery injuries are frequently considered as one entity (BCVI) and analysed in mixed populations. Material and Methods: The TraumaRegister DGU® (TR-DGU), a prospectively maintained database, was used for retrospective data analysis (01/2016-12/2023?).Inclusion Criteria: adult trauma patients (≥16 years) with severe injuries (ISS ≥ 16 points) with and without BCVI. Subgroups: carotid artery injury (CAI) and vertebral artery injury (VAI).Results: Of a total of 271,965 subjects examined, 2,243 (0.82%) presented with cerebrovascular injuries. Demographically, the study found that individuals with carotid injuries had a younger mean age (44 years), when compared to those with vertebral injuries (55 years). Multivariate analyses identified very different risk factors and associated injury patterns, for carotid and vertebral artery injuries in multiply injured patients. Conclusion: These results emphasize the importance of timely evaluation of neck vessels in patients with cervical trauma and injuries associated with loss of consciousness and skull fractures, as these factors are predictive of vascular injuries and therefore of significant complications. Vertebral and carotid artery injuries feature different risk factors that should be acknowledged in current screening and trauma management protocols.None.