2018 AANS Annual Scientific Meeting-Topic Review: Pediatric Blunt Cerebrovascular Injuries

Topic Review: Pediatric Blunt Cerebrovascular Injuries - Imaging and Management Update

Video Transcription

Video Summary

In this video, Dr. Bola discusses pediatric blunt cerebrovascular injuries, focusing on imaging and management updates. He begins by highlighting the importance of selective screening in children due to the rarity but potential severity of this type of injury. In adults, early recognition and treatment of blunt cerebrovascular injuries reduce the risk of delayed stroke. The preferred screening method is computed tomographic angiography (CTA) due to its high sensitivity. In children, diagnostic radiation poses more harm, making selective screening even more crucial. Dr. Bola introduces the Utah score, which predicts the risk of blunt cerebrovascular injury in children based on various factors such as the Glasgow Coma Scale score and type of fractures. Validation studies have shown promising results, but further research is needed. Treatment for these injuries is controversial, especially for low-grade injuries. However, medical management with antiplatelet agents, such as aspirin, is generally recommended. Endovascular treatment is rarely required, typically reserved for high-grade injuries or cases where medical management is contraindicated. Dr. Bola concludes by emphasizing the need for continued research and validation to improve the clinical prediction and screening for pediatric blunt cerebrovascular injuries.

Asset Caption

Robert John Bollo, MD, FAANS

Keywords

pediatric blunt cerebrovascular injuries

selective screening

computed tomographic angiography (CTA)

Utah score

treatment