OU Medicine Surgeon, Student Contribute to Study on Preventing Stroke After Blunt Traumatic Injury

An OU Medicine trauma surgeon and an OU College of Medicine student were among the leaders of a national research study that established new guidelines for preventing strokes in patients who have suffered a blunt traumatic injury to their necks.

Amanda Celii, M.D., and Tyler Zander, a third-year medical student, were authors on the study, which was published in the Journal of Trauma and Acute Care Surgery. The study focused on blunt cerebrovascular injury – an injury to the blood vessels in the neck. Unlike a penetrating injury such as a gunshot or stab wound, blunt cerebrovascular injuries (BCVIs) can be caused by the force of a seat belt during a car accident or a fracture in the neck, for example.

“Essentially, BCVIs occur when the blood vessels are injured or bruised in a way that clots can form, which can cause a stroke,” Celii said.

The purpose of the study was, in part, to determine how soon strokes occur after an injury to the blood vessels and how soon blood thinners should be given in an effort to prevent stroke. Trauma centers across the country have treated patients in slightly different ways, so the study was conducted in order for care to be standardized, Celii said.

OU Medicine contributed its patient data concerning BCVIs to the study, which included more than 30 such institutions around the country. The study results showed that the majority of patients who suffer a BCVI-related stroke do so in the first 72 hours after the injury occurs. That means blood thinners – often aspirin – should be given to the patient immediately, Celii said.

The study also answered a related question concerning patients who have injuries in addition to a BCVI, which is often the case. In a patient who also has a complex pelvic fracture, for example, the concern was that blood thinners would increase the risk of bleeding. However, the study showed that the risk of stroke within 72 hours outweighed the risks of giving the blood thinner.

“Because of how early the strokes can occur, the data showed us that starting blood thinners early is important,” Celii said. “Because of the results of the study, we will be rewriting our protocols for how we treat patients with BCVIs.”

The study was also an important experience for Zander, who, as a third-year student, is out of the lecture hall and into the hospital wards for his clinical rotations. Zander has wanted a career in surgery since he was young, but an experience in high school solidified his determination to go to medical school. In the summer before his senior year in Enid, Zander was working at a grain elevator to earn extra money. A friend working with him got his leg caught in an auger, and when Zander tried to help, his leg became caught as well. He was taken to OU Medicine, where his leg had to be amputated and he spent more than two months in the hospital undergoing numerous surgeries. He maintained relationships with the surgeons who saved his life.

Receiving author credit on a research publication is unusual for a medical student, but Zander has a particular drive, Celii said. When students are part of that process and develop mentors with faculty members, they tend to learn the intricacies of surgery better, she said.

Zander has already worked on eight studies at OU Medicine concerning surgery protocols. The process of clinical research especially interests him as he progresses in his journey toward becoming a physician.

“I have an interest in what we do and why we do it, looking at our protocols, and gathering information that leads to the best practices,” he said. “This study is a good example of how we can conduct studies to improve medicine.”