Update on Treatment of Blunt Cerebrovascular Injuries

Purpose of Review: This article focuses on the recent practices and advancements in the treatment of blunt cerebrovascular injuries (BCVI), and also to identify areas of future study. Recent Findings: It remains clear that antithrombotic therapy is the mainstay of therapy for preventing BCVI-related stroke. There is no difference in the type of antithrombotic therapy used, but it is critical that treatment be initiated as early as possible post-injury. The use of endovascular stents has declined dramatically from the previous decade, and their true utility in the treatment of these injuries remains unclear. One of the biggest challenges that remains in treating BCVI is when to initiate therapy in patients with concomitant injuries that may prevent treatment early post-injury, when treatment is in fact most critical. Summary: Antithrombotic therapy remains effective in the treatment of BCVI. The BCVI-related stroke rates reported across the literature remain stable between 5 and 10%. The treatment will most likely remain similar for the foreseeable future; however, there remain unknowns regarding the nuances of treatment that are mostly attributable to the relative rarity of the injuries.