From
StayCurrentMD
Update Course Rewind: Updates in Screening for Blunt Cerebrovascular Injury 2023
hosted by Dr. M. Godi
Chapter 1 of 4 · Fundamentals
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Introduction to Update Course Series
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Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
Neurologists were the biggest advocates for BCVI screening in the institution's system.
The institution had a couple of patients, one with a delayed diagnosis stroke from a BCVI that was missed, which prompted them to make a routine protocol for BCVI.
The institution determined all patients with concern should get CTA head and neck for BCVI screening.
The institution implemented BCVI screening about a year ago and has not had any delayed diagnosis since, whereas they had at least two children in the previous year who had strokes which then led to identification of their BCVI.
The institution has not had an increase in BCVI incidence after implementing screening, but has not had any delayed diagnosis.
The Utah score is the worst score out there for BCVI screening and needs a switch.
BCVI screening has been a hot topic in adult trauma for several years, and pediatric trauma is behind the ball.
According to Dr. Russell, this is one of those times where pediatric surgeons can follow the adult trauma surgeons to not miss kids with BCVI injuries.
1.3% of trauma patients will have BCVI, the same number of kids that have cervical spine injuries.
About a third of BCVI patients will have a stroke.
If you have a stroke from BCVI, your mortality can be as high as 20%.
Pediatric surgeons are screening nearly everyone for cervical spine injuries, but they're not screening kids for BCVIs.
The Memphis score is the most sensitive score for BCVI screening.
Dr. Russell would tell everyone to use the Memphis score based on everything they know.
A PTS guideline for BCVI screening is hopefully coming out at PTS in November.
The Atomic group study showed that BCVI screening is all over the place with lots of variation.
When you have many different screening tools, it means we don't know what to do.