Self-reported awareness and knowledge of blunt cerebrovascular injury among emergency, orthopedic, and anesthesiology physicians in Denmark and the Netherlands.

backgroundBlunt cerebrovascular injury (BCVI) is a rare condition resulting from blunt trauma to the cervical arteries. It most commonly affects young adults resulting in increased risk of stroke and mortality while often being subtle in presentation. Lack of national guidelines in Denmark (DK) and Netherlands (NL) places significant responsibility on physicians and insufficient knowledge may elevate stroke risks and compromise patient safety. The study aims to assess physicians’ knowledge of BCVI patients in DK and NL, including traumatic mechanisms, symptoms, treatment, and their awareness and use of guidelines for blunt cervical trauma and BCVI patients.

methodsThis international, multicenter, cross-sectional survey in DK and NL invited trauma physicians from emergency medicine, anesthesiology, and orthopedic surgery. In DK, participants were recruited via department heads using purposive sampling, and in NL via self-selection through the Dutch Association for Emergency Physicians newsletter. The questionnaire assessed demographics, BCVI guideline familiarity, and knowledge of traumatic mechanisms, symptoms, treatment, and two patient cases. Knowledge scores were calculated as the percentage of correct answers, stratified by experience, with means and 95% confidence intervals.

resultsThe study surveyed 1.642 physicians with 374 responses (22.7%). Of these, 235 (62.8%) had at least 10 years of experience, and 242 (64.7%) reported handling 1–5 trauma cases per month. Most physicians, 208 (55.6%), were familiar with blunt trauma diagnosis guidelines. Physicians had mean correct scores of 56% (95% confidence interval (CI): 54.1–58.0%) regarding BCVI-symptoms and 81.9% (95% CI: 80.2–83.6%) regarding high-risk traumatic mechanisms. When presented with an asymptomatic BCVI patient, 184 (49.9%) chose anti-platelet or anti-coagulative therapy, while 35 (9.4%) selected intravenous thrombolysis for a BCVI patient with symptoms of stroke.

conclusionsThis cross-sectional study demonstrates that physicians in DK and NL report high knowledge of traumatic mechanisms associated with BCVI but limited knowledge of high-risk symptoms and the treatment of BCVI-related stroke. These findings highlight important knowledge gaps and suggest that strengthened development and implementation of targeted guidelines within physician education may improve the recognition and management of BCVI among clinicians involved in trauma care in DK and NL. CLINICAL TRIAL NUMBER: Not applicable.