Blunt Carotid Injury in Children

Duke, Bryan J.; Partington, Michael D.

doi:10.1159/000121122

Cited by 12 publications

(3 citation statements)

References 21 publications

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“…In 1996, Duke and Partington [5]presented a case series of 5 pediatric patients with traumatic BCI. Other than this singular contribution, data regarding pediatric BCI have been limited to isolated case reports or the occasional pediatric patient included in larger adult series.…”

Section: Introductionmentioning

confidence: 99%

Pediatric Blunt Carotid Injury: A Review of the National Pediatric Trauma Registry

Lew¹,

Frumiento²,

Wald³

1999

Pediatr Neurosurg

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Blunt carotid injury (BCI) is an uncommon yet potentially devastating entity which has received little attention in the pediatric literature. In an attempt to better characterize pediatric BCI, a review of the National Pediatric Trauma Registry was performed. Records were obtained from all children diagnosed with internal or common carotid injury associated with blunt trauma. The incidence of BCI was 0.03% (15 of 57,659 blunt trauma patients). Variables examined included: age, gender, mechanism of injury, associated injuries, various injury severity scores, and outcome. Various injuries were associated with an increase in BCI incidence including chest trauma (4-fold), combined head and chest trauma (6-fold), basilar skull fractures (4-fold), intracranial hemorrhage (6-fold), and clavicle fractures (8-fold). Thirty-three percent of the patients diagnosed with BCI suffered neurological complications directly attributable to their carotid injuries. Current practices regarding screening, diagnosis, and treatment are reviewed.

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Section: Introductionmentioning

confidence: 99%

Pediatric Blunt Carotid Injury: A Review of the National Pediatric Trauma Registry

Lew¹,

Frumiento²,

Wald³

1999

Pediatr Neurosurg

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“…6,10) The incidence appears to be markedly less in children compared to adults, which may be a reflection of physiologic and anatomic differences including increased vascular S. Oshiro et al…”

Section: Discussionmentioning

confidence: 99%

Pediatric Blunt Carotid Injury. Case Report.

Oshiro

Ohnishi

Ohta

et al. 2003

Neurol. Med. Chir.(Tokyo)

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A 5-year-old boy was struck by a pickup truck, and admitted with Glasgow Coma Scale score of 14. Initial computed tomography (CT) showed no evidence of intracerebral lesions except for a skull fracture. Repeat CT 5 hours later showed hyperdense middle cerebral artery (MCA) sign, but he did not show any focal signs. Eighteen hours after the accident, he developed left hemiparesis. CT revealed a fresh infarction in the right MCA territory, associated with definite hyperdense MCA sign. He was immediately transferred to our hospital for further evaluation. Emergent angiography revealed a rat tail-shaped occlusion of the right internal carotid artery at the C-3 level. Cross-filling of the right MCA territory was insufficient for collateral circulation. He was treated conservatively because of the significant risk of hemorrhagic change from the established infarction. His hemiparesis improved gradually, and he was discharged on foot. Hyperdense MCA sign in a child is an important clinical sign for the early detection of cerebral ischemia after blunt carotid injury, before any focal signs appear.

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“…Zusammenfassend ist festzustellen, dass man bei zerebralen Ischämien junger Patienten keinesfalls auf eine subtile Gefäßdiagnostik verzichten darf. Weiterhin ist bei der Behandlung polytraumatisierter Patienten, bei denen prinzipiell vom Unfallmechanismus her an ein stumpfes Halsgefäßtrauma gedacht werden muss, eine frühzeitige Gefäßdiagnostik zwingend erforderlich (2,6). Allein hierdurch wird es möglich, traumatogene Aneurysmen frühzeitig zu diagnostizieren und zu therapieren (7) und so einem späteren daraus resultierenden embolischen Geschehen vorzubeugen.…”

Section: Diskussionunclassified