Carotid Artery Trauma: Management Based on Mechanism of Injury

Fabian, Timothy C.; George, Salem M.; Croce, Martin A.; Mangiante, Eugene C.; Voeller, Guy; Kudsk, Kenneth A.

doi:10.1097/00005373-199008000-00003

Cited by 116 publications

(47 citation statements)

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“…This time frame appears to range from hours up to 14 years, but the majority of patients seem to develop symptoms within 10 to 72 hours. [3][4][5]17,18,20,21 Diagnosing BCVI during this "silent period" affords the opportunity for treatment prior to neurologic sequelae.…”

Section: Bcvi Screening During the "Silent Period"mentioning

confidence: 99%

“…4 For patients with contraindications for heparin, the initiation of antiplatelet agents (aspirin 325 mg/d and clopidogrel 75 mg/d) has gained favor. 3,21,26 It should be noted that antithrombotic therapy is not started with patients having closed head injury or intraparenchymal hemorrhage without input from the neurosurgery service.…”

Section: Treatment: Antithromboticsmentioning

confidence: 99%

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Blunt Cerebrovascular Injuries

Cothren¹,

Moore²

2008

Current Therapy of Trauma and Surgical Critical Care

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Section: Bcvi Screening During the "Silent Period"mentioning

confidence: 99%

Section: Treatment: Antithromboticsmentioning

confidence: 99%

Blunt Cerebrovascular Injuries

Cothren¹,

Moore²

2008

Current Therapy of Trauma and Surgical Critical Care

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“…Surgical iatrogenic carotid injuries are rarely reported, as no mention of such injuries was found in three major reviews of carotid artery injuries [7][8][9]. In this report involving an injury to the common carotid artery during the dissection of a neck mass in a young man, primary suturing of the injury would have caused stenosis of the artery.…”

Section: Discussionmentioning

confidence: 89%

“…In a review of 71 iatrogenic arterial injuries, carotid artery injuries accounted for 5.6% of the cases [6], all of which were due to the inadvertent introduction of catheters into the carotid artery during placement of lines in the internal jugular vein. Iatrogenic carotid injuries due to surgery, however, are rarely reported, and no mention of them was found in three major reviews of carotid artery injuries [7][8][9]. Here we report an injury to the common carotid artery during the dissection of a neck mass in a young man and describe a new technique for the repair of the artery.…”

Section: Introductionmentioning

confidence: 89%

Repair of Common Carotid Artery Injury with an External Carotid Artery Flap

2004

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Objectives: To describe a new technique to repair injuries of the common carotid artery. Clinical Presentation and Intervention: A 30-year-old man sustained an iatrogenic injury to the left common carotid artery during surgical dissection of a left branchial cyst. The artery was repaired as follows: the left external carotid artery was ligated distally, its stump was longitudinally opened to create an arterial flap, which was then used to repair the defect in the common carotid artery. The patient remained free of any symptoms throughout 1 year of follow-up. Conclusion: Use of an external carotid flap provides an alternative method of repairing an injured carotid artery.

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“…The importance of early detection and treatment is well known, but most patients do not present with focal signs or symptoms and frequently have a multitude of other severe injuries, further confusing, and delaying the diagnostic work-up. [3][4][5]7,8,15,19) We describe a pediatric case of blunt carotid injury in which hyperdense middle cerebral artery (MCA) sign was detected by computed tomography (CT) before the patient showed any focal signs.…”

Section: Introductionmentioning

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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Carotid Artery Trauma: Management Based on Mechanism of Injury

Cited by 116 publications

References 0 publications

Blunt Cerebrovascular Injuries

Blunt Cerebrovascular Injuries

Repair of Common Carotid Artery Injury with an External Carotid Artery Flap

Pediatric Blunt Carotid Injury. Case Report.

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