Clinical and Epidemiological Characteristics, Trauma Mechanisms, and Outcomes of Blunt Cervical Vascular Injury

Abstract

Background: Head and neck trauma and its associated injuries contribute substantially to mortality and neurological morbidity. Although relatively uncommon, blunt cervical vascular injury (BCVI) can have severe clinical consequences if not recognized early. Objectives: This study aimed to assess the clinical and epidemiological characteristics, trauma mechanisms, and clinical outcomes of BCVI among patients admitted to hospitals in Ilam, Iran. Methods: In this retrospective descriptive study, 88 patients with BCVI admitted to hospitals in Ilam were included. Data were collected using a checklist based on medical records and included demographic characteristics, clinical findings, injured vessel type, trauma mechanism, Glasgow Coma Scale (GCS) score, oxygen saturation, systolic blood pressure, injury severity, and patient outcomes. Vascular injury was defined as any traumatic lesion involving the vertebral artery (VA), common or internal carotid artery (CCA/ICA), or other cervical vascular structures. Data were analyzed using SPSS version 20 with descriptive statistics, including the mean, standard deviation, and frequency distribution. Results: Among the 88 patients, 34 had a VA injury, 46 had a CCA/ICA injury, and 8 had injuries to other cervical vessels. Motorcycle and bicycle accidents were the most common trauma mechanisms (53.4%), followed by falls from height and car accidents. Overall, 61.4% of patients had moderate injuries, whereas severe trauma was more frequent in the VA injury group. Most patients exhibited physiological instability, with high prevalence rates of a low GCS score (85.2%), oxygen saturation < 90% (96.6%), and systolic blood pressure < 90 mmHg (93.2%). Complete recovery was observed in only 20.5% of patients, and mortality was approximately 31%. Conclusions: Motorcycle and bicycle accidents were the most common mechanisms of BCVI in this setting. Most patients presented with marked physiological instability on admission, and VA injury was associated with greater trauma severity. These findings underscore the importance of early recognition and prompt clinical assessment in patients with blunt cervical trauma.