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Báo cáo y học: " Diagnosis of carotid arterial injury in major trauma using a modification of Memphis criteria"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Diagnosis of carotid arterial injury in major trauma using a modification of Memphis criteria | Ciapetti et al. Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 2010 18 61 http www.sjtrem.eom content 18 1 61 SCANDINAVIAN JOURNAL OF emergency medicine ORIGINAL RESEARCH Open Access Diagnosis of carotid arterial injury in major trauma using a modification of Memphis criteria 1 2 1 1 1 3 Marco Ciapetti Alessandro Circelli Giovanni Zagli Maria Luisa Migliaccio Rosario Spina Alessandro Alessi Manlio Acquafresca4 Marco Bartolini4 Adriano Peris1 Abstract Background Incidence of Blunt Cerebrovascular Injuries BCVI after head injury has been reported as 0.5-1 of all admissions for blunt trauma with a high stroke and mortality rate. The purpose of this study is to evaluate if a modification of Memphis criteria could improve the rate of BCVI diagnosis. Methods Trauma patients consecutively admitted to Intensive Care Unit ICU from Jan 2008 to Oct 2009 were considered for the study. Memphis criteria comprehend basilar skull fracture with involvement of the carotid canal cervical spine fracture neurological exam not explained by brain imaging Horner s syndrome LeFort II-III fractures and neck soft tissue injury. As single criteria modification we included all patients with petrous bone fracture even without carotid canal involvement. In all patients at risk of BCVI 64-slice angio-CT-scans was performed. Results During the study period 266 patients were admitted to the ICU for blunt major trauma. Among them 162 presented traumatic brain injury or cervical spine fracture. In accordance with the proposed modified-Memphis criteria 53 patients showed risk factors for BCVI compared to 45 using the original Memphis criteria. Among the 53 patients 6 resulted as having carotid lesions 2.2 of all blunt major traumas one patient more than when using Memphis criteria . Anticoagulant therapy with low molecular weight heparin was administered in all patients. No stroke or hemorrhagic complications occurred. Clinical examination at 6-months showed no central .