Document Type
Article
Publication Date
12-22-2025
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.
Recommended Citation
Cewe, Paulina; Staartjes, Victor E.; El-Hajj, Victor Gabriel; Al-Rikabi, Ihab Ahmad; Musmar, Basel; Roy, Joana M.; Troung, Dennis; Beckman, Mats; Ohlsson, Marcus; Jabbour, Pascal; Elmi-Terander, Adrian; and Edström, Erik, "Epidemiology and Screening of Traumatic Vertebral Artery Injuries at a Large Scandinavian Level 1 Trauma Center" (2025). Jefferson Hospital Staff Papers and Presentations. Paper 72.
https://jdc.jefferson.edu/tjuhpapers/72
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License
Language
English
Comments
This article is the author's final published version in Neurospine, Volume 22, Issue 4, December 2025, Pages 905-915.
The published version is available at https://doi.org/10.14245/ns.2551070.535. Copyright © The Korean Spinal Neurosurgery Society.