Commentary on 'A modern approach to cervical vascular injuries'.

摘要

Cervical vascular injuries, both penetrating and blunt, when not managed appropriately cany devastating consequences both in terms of mortality and debilitating neurologic sequelae. Drs Cox and O'Brien have provided an important update for those who care for patients with these injuries. We would like to focus on three specific aspects of diagnosis and treatment that are mentioned by the authors. First, the resurrection of the physical exam in diagnosis of penetrating cervical vascular injuries. As they detail, 3 major prospective studies encompassing more than 500 patients have validated the importance of a physical exam in guiding patient care. By moving from the traditional "zone"-based approach to a more logical exam-based approach, the rate of negative neck exploration has been dramatically reduced and the outcome of patients with injuries improved. In our opinion, the available data overwhelmingly support this approach.