Screening Multidetector Computed Tomography Angiography in the Evaluation on Blunt Neck Injuries: An Evidence-Based Approach

Blunt cerebrovascular injuries (BCVI) can cause ischemic stroke and are associated with high mortality rates. These injuries may have an initial silent course and if recognized in a timely fashion can be treated before neurologic deficit occurs. This has led to the growing implementation of aggressive screening programs to detect and thereby treat BCVI early, before onset of symptoms. Digital subtraction angiography is the diagnostic reference standard for diagnosing BCVI. However, in recent years, there has been a renewed interest in the use of noninvasive techniques, such as multidetector computed tomography angiography (MDCTA) for the evaluation of these patients. The accuracy of MDCTA with respect to digital subtraction angiography is not completely elucidated; however, MDCTA shows a level of accuracy sufficient to serve as an initial screening examination for blunt cerebrovascular injuries.