Epidemiology and Screening of Traumatic Vertebral Artery Injuries at a Large Scandinavian Level 1 Trauma Center.

Authors

• Paulina Cewe
• Victor E Staartjes
• Victor Gabriel El-Hajj
• Ihab Ahmad Al-Rikabi
• Basel Musmar
• Joana M Roy
• Dennis Troung
• Mats Beckman
• Marcus Ohlsson
• Pascal Jabbour
• Adrian Elmi-Terander
• Erik Edström

Publication/Presentation Date

12-1-2025

Abstract

OBJECTIVE: Traumatic vertebral artery injuries (tVAIs) are uncommon but potentially devastating if missed. While computed tomography angiography (CTA) is routinely used for diagnosis, data on the number needed to image (NNI) remain limited. We hence analyzed tVAI epidemiology and imaging practices at a major Scandinavian level 1 trauma center.

METHODS: A retrospective study (2013-2020) was performed based on a single-center trauma registry. Patients were grouped based on CTA imaging protocol used; selective screening (2013-2017) and universal screening (2018-2020). Imaging protocols, treatment strategies, and outcomes were analyzed.

RESULTS: Among 2,843 patients admitted with level 1 trauma and receiving CTA imaging, 62 had a tVAI (2.2%) yielding a NNI of 46 patients to diagnose 1 tVAI. Twenty-five of these patients (40.3%) were found to have a posterior circulation stroke, resulting in an incidence of 0.9%, and a NNI of 114 to diagnose 1 stroke on CTA. NNIs for both tVAI and stroke detection increased with adoption of universal screening (tVAI: 35→65; stroke: 90→149). However, the detection rate of tVAI during the universal screening period was not significantly higher than during the selective screening period (p=0.261).

CONCLUSION: In our level 1 trauma cohort, the incidence of tVAI was 2.2% and stroke rate 0.9%. The NNI rose with universal screening, yet detection rates did not improve. These findings suggest that selective screening based on risk factors may be more efficient than a universal approach. Further research is needed to balance diagnostic accuracy with resource use in trauma care.

Volume

22

Issue

4

First Page

905

Last Page

915

ISSN

2586-6583

Published In/Presented At

Cewe, P., Staartjes, V. E., El-Hajj, V. G., Al-Rikabi, I. A., Musmar, B., Roy, J. M., Troung, D., Beckman, M., Ohlsson, M., Jabbour, P., Elmi-Terander, A., & Edström, E. (2025). Epidemiology and Screening of Traumatic Vertebral Artery Injuries at a Large Scandinavian Level 1 Trauma Center. Neurospine, 22(4), 905–915. https://doi.org/10.14245/ns.2551070.535

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

41508580

Department(s)

Administration and Leadership

Document Type

Article