Most recently, Mayberry et al1 published an article calling into question the cost efficiency of aggressive screening and diagnosis of blunt carotid artery injury. The diagnosis and treatment of blunt cerebrovascular injury have received much attention in the literature during the past several years as the incidence approaches between 0.86% to 1.50% of blunt traumatic injuries. Biffl et al,2 Cothren et al,3 Davis et al,4 and Miller et al5 have arguably led many to ask: How far should one pursue this type of injury? Furthermore, which modality is best suited for diagnosis, what are appropriate measures to treat each injury, and should follow-up angiography be instituted? Clearly, many institutions have taken notice and are finding that with an aggressive approach to blunt cerebrovascular injury many more patients are diagnosed and treated for a potentially costly and severely debilitating injury with life-threatening implications.
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