Best Evidence Topic report: Antithrombotic therapy and endovascular intervention for blunt cerebrovascular injury

Emerg Med J. 2024 Apr 22;41(5):337-339. doi: 10.1136/emermed-2023-213815.

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.

Keywords: major trauma management; stroke; thrombo-embolic disease.