Clinical Importance of the “Seat Belt Sign” in Blunt Trauma to the Neck

• Published in: The American surgeon Vol. 68; no. 5; pp. 441 - 445
• Main Authors: Diperna, Costanzo A., Rowe, Vincent L., Terramani, Thomas T., Salim, Ali, Hood, Douglas B., Velmahos, George C., Weaver, Fred A.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.05.2002; Southeastern Surgical Congress; SAGE PUBLICATIONS, INC
• Subjects: Accidents, Traffic; Adult; Biological and medical sciences; Carotid Artery Injuries - diagnostic imaging; Carotid Artery Injuries - etiology; Female; Glasgow Coma Scale; Humans; Injuries; Male; Medical sciences; Miscellaneous; Neck; Neck Injuries - diagnostic imaging; Neck Injuries - etiology; Seat belts; Seat Belts - adverse effects; Signs; Traumas. Diseases due to physical agents; Ultrasonography; Wounds, Nonpenetrating - complications; Human; Radiodiagnosis; Cardiovascular disease; Safety belt; Review; Trauma; Arterial disease; Vascular disease; Symptomatology; Carotid; Medical imagery; Computerized axial tomography; Neck; Diagnosis
• ISSN: 0003-1348; 1555-9823
• DOI: 10.1177/000313480206800509

Currently a carotid duplex scan is the initial screening modality routinely used to evaluate occult extracranial carotid artery injuries secondary to blunt neck trauma. The objective of this study was to investigate the role of carotid artery duplex scanning in patients who suffered blunt trauma to the neck with a “seat belt sign.” The medical records of 131 consecutive patients who sustained blunt trauma to the neck from a motor vehicle accident were reviewed. Patients with the cervical seat belt sign underwent a complete physical examination and carotid duplex scan in an accredited vascular laboratory. An intimal flap with severe carotid artery stenosis was found in one of 131 patients (0.76%). This patient has multiple injuries to the face, head, chest, lateralizing neurological signs, and a Glasgow Coma Scale score of 8. In an era of cost containment, resource consumption should target appropriate populations. A cervical seat belt sign should not serve as a sole indicator for evaluation of the carotid artery in the absence of other pertinent signs or symptoms.