CT Angiography Aids Decision Making for Penetrating Neck Trauma

Physical examination of patients with penetrating neck trauma is specific, but CT angiography improves sensitivity for identification of significant vascular, aerodigestive, and neurologic injury.

Researchers retrospectively analyzed records for patients with penetrating injuries to the neck at a single level I trauma center from 2000 to 2005 to assess management, outcomes, and the role of computed tomographic angiography (CTA) in decision making. Before 2003, decisions to perform surgery were based on clinical assessment and zone of injury, whereas after 2003, CTA was routinely performed and decisions were based on CTA findings. Of 120 consecutive patients, 55 were excluded because the wound was superficial to the platysma, the patient died before operative intervention, or exploration was undertaken emergently to control hemorrhage.

Among the remaining 65 patients, 13 had zone 1 injuries, 50 had zone 2 injuries, and 16 had zone 3 in…

Reviewing Author

John A. Marx, MD, FAAEM, FACEP