Protect That Neck! Management of Blunt and Penetrating Neck Trauma

Emerg Med Clin North Am. 2023 Feb;41(1):35-49. doi: 10.1016/j.emc.2022.09.005.

Abstract

Blunt and penetrating vascular injuries to the neck represent a significant burden of mortality and disability among trauma patients. Blunt cerebrovascular injury can present with signs of stroke either immediately or in a delayed fashion. Most injuries are detected with computed tomography angiogram and managed by antiplatelet agents or unfractionated heparin. In contrast, for patients presenting with penetrating neck injuries, assessment for hard signs of vascular and aerodigestive injury should be done and prompt emergent surgical consultation if present. Overall management priorities for penetrating neck injuries focus on airway management, hemorrhage control, and damage control resuscitation before definitive surgical repair.

Keywords: BCVI; Blunt cerebrovascular injury; Computed tomography angiography; Neck trauma; Penetrating neck trauma; Vascular injury; Vascular trauma.

Publication types

  • Review

MeSH terms

  • Chest Pain
  • Heparin
  • Humans
  • Neck
  • Neck Injuries* / diagnosis
  • Neck Injuries* / therapy
  • Wounds, Nonpenetrating* / diagnosis
  • Wounds, Nonpenetrating* / therapy
  • Wounds, Penetrating* / diagnosis
  • Wounds, Penetrating* / therapy

Substances

  • Heparin