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Best Evidence Topic reports
Best Evidence Topic report: Antithrombotic therapy and endovascular intervention for blunt cerebrovascular injury
  1. Luke Cutts1,
  2. Chris Gray2,
  3. Navdeep Gill1,
  4. Daniel Horner1,3
  1. 1Critical Care Department, Northern Care Alliance NHS Foundation Trust, Salford, Manchester, UK
  2. 2Emergency Department, Manchester University NHS Foundation Trust, Manchester, UK
  3. 3Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK
  1. Correspondence to Professor Daniel Horner, Critical Care Department, Northern Care Alliance NHS Foundation Trust, Salford, UK; daniel.horner{at}nca.nhs.uk

Abstract

A short cut review of the literature was carried out to examine the evidence supporting antithrombotic treatment and/or endovascular therapy to reduce mortality and/or prevent future stroke following blunt cerebrovascular injury (BCVI). Five papers were identified as suitable for inclusion using the reported search strategy. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of the best papers are tabulated. It is concluded that in patients with BCVI confirmed by CT angiography, there is limited evidence to support screening for, or treating BCVI. In confirmed BCVI where the risk of stroke is felt to outweigh the risk of bleeding, antiplatelet therapy appears to be as effective as therapeutic anticoagulation.

  • thrombo-embolic disease
  • major trauma management
  • stroke

https://doi.org/10.1136/emermed-2023-213815

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    Footnotes

    • Handling editor Richard Body

    • X @cgraydoc, @rcemprof

    • Correction notice Since this paper first published, a disclaimer statement has been added.

    • Contributors All authors contributed equally to this work. LC and CG conducted the initial searches, extracted relevant papers and drafted the initial manuscript. NG and DH checked the searches, amended the evidence table and redrafted the comments/bottom line. All authors have seen and reviewed the final version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Disclaimer Best Evidence Topic reports (BETs) summarise the evidence pertaining to particular clinical questions. They are not systematic reviews, but rather contain the best (highest level) evidence that can be practically obtained by busy practising clinicians. The search strategies used to find the best evidence are reported in detail in order to allow clinicians to update searches whenever necessary. Each BET is based on a clinical scenario and ends with a clinical bottom line which indicates, in the light of the evidence found, what the reporting clinician would do if faced with the same scenario again. This BET was first published on the BestBETs website at http://www.bestbets.org and has been reproduced with permission.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer-reviewed.