{
  "abstract": "Background Blunt cerebrovascular injury (BCVI) is a well-recognized complication of cervical trauma. However, the impact of cervical spine surgery on BCVI outcomes remains poorly defined. We sought to evaluate the clinical and radiographic outcomes of BCVI in operative cervical spine patients.Methods We retrospectively identified patients within the Yale-New Haven Health System who underwent cervical spine surgery from 2013 to 2025 for fracture, subluxation, or trauma. Vascular imaging was reviewed to identify BCVI. Patient demographics, clinical outcomes, and radiographic follow-up were analyzed.Results Among 486 patients meeting the inclusion criteria, 225 (46.3%) had pre-operative vascular imaging. BCVI was identified in 55 patients (24.4%; 34.5% female; median age 62 [IQR 42-76]), involving 69 vessels. Presenting Denver grades were Grade I in 50.7%, Grade II in 14.5%, Grade III in 4.3%, Grade IV in 29.0%, and Grade V in 1.4%. Four patients (7.3%) suffered stroke at presentation, including 2 with multi-vessel injury. Post-operatively, 3 patients (5.5%) developed new strokes in the affected territory. All delayed strokes occurred within 10 days of BCVI diagnosis. Radiographic outcomes were favorable, with 71.9% of vessels demonstrating interval improvement at a median follow-up of 4.3 months [IQR 0.4-6.8].Treatment strategies consisted of aspirin in 52.7% patients, anticoagulation alone in 9.1% patients, and combined treatment in 3.6% patients. Antithrombotic therapy was initiated within 7 days in 75.0% patients and within 3 days in 33.3% patients. There was no return to the OR for post-operative hemorrhage.Conclusions BCVI is common among patients undergoing operative management for cervical spine trauma. Injury severity appears lower than in broader trauma cohorts, which may reflect survival and surgical selection bias. Strokes occur early after diagnosis, underscoring a critical window for monitoring and management. Additional ischemic events may also occur following surgical manipulation, likely reflecting the intimate anatomic relationship between the cervical vasculature and bony structures.Disclosures V. Chinnasamy: None. E. Gilmore: None. T. Duda: None. J. Haynes: None. L. Kolb: None. E. Mendel: None. J. Grauer: None. R. Hebert: None. J. Schindler: None. C. Matouk: None. N. Sujijantarat: None.",
  "authors": [
    {
      "affiliations": [
        "Neurosurgery, Yale School of Medicine, New Haven, CT"
      ],
      "name": "V Chinnasamy"
    },
    {
      "affiliations": [
        "Neurology, Yale School of Medicine, New Haven, CT"
      ],
      "name": "E Gilmore"
    },
    {
      "affiliations": [
        "Neurosurgery, Yale School of Medicine, New Haven, CT"
      ],
      "name": "T Duda"
    },
    {
      "affiliations": [
        "Neurosurgery, Yale School of Medicine, New Haven, CT"
      ],
      "name": "J Haynes"
    },
    {
      "affiliations": [
        "Neurosurgery, Yale School of Medicine, New Haven, CT"
      ],
      "name": "L Kolb"
    },
    {
      "affiliations": [
        "Neurosurgery, Yale School of Medicine, New Haven, CT"
      ],
      "name": "E Mendel"
    },
    {
      "affiliations": [
        "Orthopedic Surgery, Yale School of Medicine, New Haven, CT"
      ],
      "name": "J Grauer"
    },
    {
      "affiliations": [
        "Neurosurgery, Yale School of Medicine, New Haven, CT"
      ],
      "name": "R Hebert"
    },
    {
      "affiliations": [
        "Neurology, Yale School of Medicine, New Haven, CT"
      ],
      "name": "J Schindler"
    },
    {
      "affiliations": [
        "Neurosurgery, Yale School of Medicine, New Haven, CT",
        "Radiology, Yale School of Medicine, New Haven, CT"
      ],
      "name": "C Matouk"
    },
    {
      "affiliations": [
        "Neurosurgery, Yale School of Medicine, New Haven, CT"
      ],
      "name": "N Sujijantarat"
    }
  ],
  "title": "E-047 The fate of blunt cerebrovascular injury after cervical spine surgery",
  "uid": "5c9a7318-d350-5925-9968-dcba2acd2c90"
}