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JAMA Network Clinical Guideline Synopsis
December 16, 2020

Evaluation and Management of Blunt Cerebrovascular Injury

Author Affiliations
  • 1Department of Surgery, Denver Health Medical Center, Denver, Colorado
JAMA Surg. 2021;156(2):193-194. doi:10.1001/jamasurg.2020.5643

Blunt cerebrovascular injury (BCVI) can result in stroke, leading to morbidity and mortality. This practice management guideline addresses 4 population, intervention, comparison, and outcome (PICO) questions: (1) Should a screening protocol vs no screening protocol be used to detect BCVI? (2) Should a screening computed tomography angiogram vs no screening computed tomography angiogram be used to detect BCVI in adult patients with high-risk and low-risk cervical spine injuries? (3) Should antithrombotic therapy vs no antithrombotic therapy be used to prevent stroke or mortality in adult patients with BCVI? (4) Should routine endovascular stenting as an adjunct to antithrombotic therapy vs antithrombotic therapy alone be used to reduce the risk of stroke or mortality in adult patients with grade II or III BCVI? This guideline is reviewed in this synopsis, including an assessment based on the National Academy of Medicine Standards for Developing Trustworthy Clinical Practice Guidelines (Table).

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