Abstract
High energy trauma has been considered a risk factor for blunt cerebrovascular injuries
(BCVI). The purpose of this study was to determine the incidence and risk factors
for BCVI specifically in patients with maxillofacial fractures in an urban level I
trauma center. A retrospective cohort study of patients aged ≥ 18 years, admitted
to Massachusetts General Hospital (MGH) between 2007 and 2017, was implemented. There
were 23,394 patients treated and entered into the MGH Trauma Registry: 22,287 sustained
blunt trauma. Of the total blunt trauma patients, 68 (0.3%) had BCVI. There were 2421
patients with CMF fractures from blunt trauma (mean ± standard deviation age, 53 ± 22
years; 29.9% female included as study subjects, of whom 24 (1.0%) had BCVI). In a
multivariate model, all mandible fracture (odds ratio (OR) 4.3, 95% confidence interval
(CI) 1.6–11.6, P = 0.004), crush injury, defined as blunt compression injury (OR 11.1, 95% CI 2.1–58.1,
P = 0.004), and cervical spine injury (OR 10.1, 95 CI 3.7–27.5, P < 0.001) were independent risk factors for BCVI. Mortality was 4.3 times higher in
craniomaxillofacial fracture patients with BCVI versus those without BCVI; complications
of BCVI (stroke) contributed to the majority of deaths. Appropriate screening and
treatment of BCVI in patients with maxillofacial fractures is important.
Keywords
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Article info
Publication history
Published online: December 21, 2022
Accepted:
December 5,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
