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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. 1 Critical Care Department, Northern Care Alliance NHS Foundation Trust, Salford, Manchester, UK
  2. 2 Emergency Department, Manchester University NHS Foundation Trust, Manchester, UK
  3. 3 Division 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

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Footnotes

  • Handling editor Richard Body

  • X @cgraydoc, @rcemprof

  • 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.

  • Competing interests None declared.

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