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This retrospective single-center study (2013–2020) evaluated tVAI epidemiology and CTA imaging practices in 2,843 level 1 trauma patients, comparing selective screening (2013–2017) with universal screening (2018–2020). tVAI occurred in 62 patients (2.2%), with a number needed to image of 46, while posterior circulation stroke occurred in 25 patients (0.9%) with a NNI of 114.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/epidemiology-and-screening-of-traumatic-vertebral-artery-injuries-at-a-large-scandinavian-level-1-trauma-center/459880/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/epidemiology-and-screening-of-traumatic-vertebral-artery-injuries-at-a-large-scandinavian-level-1-trauma-center/459880.png","ImageObject",300,407,{"name":92,"@type":93},"Pentious","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the main objective of the study?","Question",{"text":112,"@type":113},"To analyze the epidemiology of traumatic vertebral artery injuries and assess imaging practices, including how many patients needed to undergo CTA to identify tVAI.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were patients grouped for screening and imaging protocols?",{"text":117,"@type":113},"Patients were grouped by the CTA imaging protocol used: selective screening from 2013 to 2017 and universal screening from 2018 to 2020.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the key findings about incidence and number needed to image (NNI)?",{"text":121,"@type":113},"tVAI incidence was 2.2% (62 of 2,843) with an NNI of 46 to diagnose 1 tVAI. Posterior circulation stroke incidence was 0.9% with an NNI of 114 to diagnose 1 stroke.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},459880,1791007381,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},1374404730887,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Neurospine 2025;22(4):905-915. [https://doi.org/10.14245/ns.2551070.535](https://doi.org/10.14245/ns.2551070.535)  \nNeurospine  \npISSN 2586-6583 eISSN 2586-6591  \nOriginal Article  \nCorresponding Author  \nVictor E. Staartjes  \n [https://orcid.org/0000-0003-1039-2098](https://orcid.org/0000-0003-1039-2098)  \nDepartment of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden [Email: victoregon.staartjes@usz.ch](Email: victoregon.staartjes@usz.ch)  \n[Received: July 9](Received: July 9), 2025  \nRevised: August 31, 2025  \nAccepted: September 15, 2025  \nSee the commentary “Epidemiology and Screening of Traumatic Vertebral Artery Injuries at a Large Scandinavian Level 1 Trauma Center” via [https://doi](https://doi).  \norg/10.14245/ns.2551774.887.  \nThis is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ([https://creativecom](https://creativecom)[mons.org/licenses/by-nc/4.0/](mons.org/licenses/by-nc/4.0/)) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.  \nCopyright © 2025 by the Korean Spinal Neurosurgery Society  \nEpidemiology and Screening of Traumatic Vertebral Artery Injuries ata Large Scandinavian Level 1 Trauma Center  \nPaulina Cewe1,2, Victor E. Staartjes1,3,4, Victor Gabriel El-Hajj1,  \nIhab Ahmad Al-Rikabi1, Basel Musmar5, Joana M Roy5, Dennis Troung2, Mats Beckman2, Marcus Ohlsson1,6, Pascal Jabbour5, Adrian Elmi-Terander1,3,7,8, Erik Edström1,3  \n1Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden  \n2Department of Trauma and Musculoskeletal Radiology, Karolinska University Hospital, Stockholm, Sweden 3Capio Spine Center Stockholm, Löwenströmska Hospital, Upplands Väsby, Sweden  \n4Machine Intelligence in Clinical Neuroscience & Microsurgical Neuroanatomy (MICN) Laboratory, Department of Neurosurgery, University Hospital Zurich, Clinical Neuroscience Center, University of Zurich, Zurich, Switzerland  \n5Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA  \n6Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden 7Department of Medical Sciences, Örebro University, Örebro, Sweden 8Department of Surgical Sciences, Uppsala University, Uppsala, Sweden  \nObjective: Traumatic vertebral artery injuries (tVAIs) are uncommon but potentially devastating if missed. While computed tomography angiography (CTA) is routinely used for diagnosis, data on the number needed to image (NNI) remain limited. We hence analyzed tVAI epidemiology and imaging practices at a major Scandinavian level 1 trauma center. Methods: A retrospective study (2013–2020) was performed based on a single-center trauma registry. Patients were grouped based on CTA imaging protocol used; selective screening (2013–2017) and universal screening (2018–2020) . Imaging protocols, treatment strategies, and outcomes were analyzed.  \nResults: Among 2,843 patients admitted with level 1 trauma and receiving CTA imaging, 62 had a tVAI (2.2%) yielding a NNI of 46 patients to diagnose 1 tVAI. Twenty-five of these patients (40.3%) were found to have a posterior circulation stroke, resulting in an incidence of 0.9%, and a NNI of 114 to diagnose 1 stroke on CTA. NNIs for both tVAI and stroke detection increased with adoption of universal screening (tVAI: 35→65; stroke: 90→ 149) . However, the detection rate oftVAI during the universal screening period was not significantly higher than during the selective screening period (p = 0.261) .  \nConclusion: In our level 1 trauma cohort, the incidence oftVAI was 2. 2% and stroke rate 0.9% . The NNI rose with universal screening, yet detection rates did not improve . These findings suggest that selective screening based on risk factors may be more efficient than a universal approach. Further research is needed to balance diagnostic accuracy with resource use in trauma care .  \nKeywords: Trauma, Cervical","cbCaicVQR5shdczp","https://ap.wps.com/l/cbCaicVQR5shdczp","pdf",368088,11,"English","# Objective\n# Methods\n# Results\n# Conclusion\n# Introduction\n## Incidence and clinical importance of tVAI\n## Denver criteria and screening protocols\n## Biffl scale and stroke risk by grade","[{\"question\":\"What was the main objective of the study?\",\"answer\":\"To analyze the epidemiology of traumatic vertebral artery injuries and assess imaging practices, including how many patients needed to undergo CTA to identify tVAI.\"},{\"question\":\"How were patients grouped for screening and imaging protocols?\",\"answer\":\"Patients were grouped by the CTA imaging protocol used: selective screening from 2013 to 2017 and universal screening from 2018 to 2020.\"},{\"question\":\"What were the key findings about incidence and number needed to image (NNI)?\",\"answer\":\"tVAI incidence was 2.2% (62 of 2,843) with an NNI of 46 to diagnose 1 tVAI. Posterior circulation stroke incidence was 0.9% with an NNI of 114 to diagnose 1 stroke.\"}]","Epidemiology and Screening of Traumatic Vertebral Artery Injuries at a Large Scandinavian Level 1 Trauma Center | PDF",1790757158,28]