Comments on the Aetiology of Indirect Traumatic Thrombosis of the Internal Carotid

Arseni, C; Maretsis, M; Dumitrescu, Laura

doi:10.1055/s-2008-1053485

Cited by 6 publications

(6 citation statements)

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“…A free interval before the onset of unconsciousness is typical in cases of blunt carotid trauma, as dissection of the intimai layer and progressive thrombosis can follow a blunt carotid trauma with a latency period of up to 24 hours. [15][16][17] Mooney and Bessen 18 described a case of late onset of cerebral symptoms 2 weeks after blunt carotid trauma. Besides cerebral ischemia following common or internal carotid artery occlusion, cerebral embolization from a thrombus in the artery may also be causal for neurologic symptoms and may explain the latency of the onset of deficits.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic and Therapeutic Management of Bilateral Carotid Artery Occlusion Caused by Near-Suicidal Hanging

Maier¹,

Fradis²,

Malatskey³

et al. 1999

Ann Otol Rhinol Laryngol

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In cases of attempted suicide by hanging, a combination of mechanisms causing local destruction of the pharynx, larynx, vessels, and spine, as well as neurologic complications, has to be considered. We present a case of hanging in which a deeply unconscious patient without any palpaple pulsation of the carotid arteries was referred to our otolaryngology department. Computed tomography and angiography showed parapharyngeal air, complete obstruction of both common carotid arteries, and a compensatory circulation through the vertebral arteries. Three hours after the trauma, surgical exploration with resection of the enrolled intima of both carotid arteries and repair of the pharynx was performed. The patient awoke with an infarct of the right hemisphere with incomplete left hemiparesis the next day, but symptoms slowly declined during the following months, and the patient learned swallowing again perfectly. We conclude from our experience that in near-hanged patients a prompt onset of adequate diagnostic and therapeutic measures is mandatory, as good neurologic and functional results may occur even in cases with coma and severe destruction of the carotid arteries and pharyngeal and laryngeal structures. Surgical repair of blunt carotid lesions is recommended and may be crucial for a good outcome.

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Section: Discussionmentioning

confidence: 99%

Diagnostic and Therapeutic Management of Bilateral Carotid Artery Occlusion Caused by Near-Suicidal Hanging

Maier¹,

Fradis²,

Malatskey³

et al. 1999

Ann Otol Rhinol Laryngol

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“…The relevant literature quotes an incidence ranging between 0.11% and 3%. 4,12,13 The higher incidence is likely to result from small denominators representing small number of cohort patients since Arseni and associates from the pre-CT era evaluated an enormous number (19,664) of head injury patients and found 22 cases with thrombosis of the ICA (0.11%). 12 In the 1990s, Rommel and associates found an incidence of 3.3% (2/60) 13 and Berlot and associates reported an incidence of 2.7% (4/145).…”

Section: Discussionmentioning

confidence: 99%

“…4,12,13 The higher incidence is likely to result from small denominators representing small number of cohort patients since Arseni and associates from the pre-CT era evaluated an enormous number (19,664) of head injury patients and found 22 cases with thrombosis of the ICA (0.11%). 12 In the 1990s, Rommel and associates found an incidence of 3.3% (2/60) 13 and Berlot and associates reported an incidence of 2.7% (4/145). 4 Specific reviews of patients only with skull base fractures suggest that the likelihood of such an injury triples if the fracture crosses the trajectory of the petrous and/or cavernous ICA.…”

Section: Discussionmentioning

confidence: 99%

Malignant Cerebral Infarction Secondary to Internal Carotid Injury in Closed Head Trauma: Good Outcome with Aggressive Treatment

2005

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A 25-year-old male patient in whom occlusion of the internal carotid artery developed secondary to a skull base fracture is presented. The diagnosis of internal carotid artery occlusion was reached 12 hours after the admission and 17 hours after the injury. The patient was initially treated for ischemic edema and when the patient showed signs of cerebral herniation, decompressive craniectomy was necessary. The outcome was good. The clinical and radiologic characteristics of internal carotid artery occlusion in closed head injury are highlighted and treatment options are reviewed in light of pertinent literature.

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“…Karotisverletzungen kommen h~iufig nach Verkehrsun-fNlen, Schl~igereien oder Stª vor, seltener nach Strangulationen oder nach digitaler Karotiskompression [1,4,5,11,31,32,43]. Wichtigste Voraussetzung ist die direkte stumpf-mechanische Gewatteinwirkung gegen den Hals, die zu einem IntimariB mit aufgepfropfter Thrombose fª kann; dazu gibt es verschiedene Fallberichte [1,2,13,14,16,17,24,27,34].…”

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“…Satemus und Fuchs [35] haben 65 Todesf~ille nach erfolgter Reanimation (mit Intubation) ohne vorg~ingiges Trauma untersucht und hierbei in 3 F~illen Karotis-Intimampturen nachgewiesen. Dazu auch [1,4,6,10,15]. Zumeist war der Abschnitt der Bifurkation, insbesondere der unmittelbar kranial angrenzende Teil betroffen.…”

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Seltene Form einer cerebralen Embolie nach Karotistrauma

1997

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Rechtsmedizin (1997) 7 : 90-94 9 Springer-Verlag 1997 Th. Sigrist 9 Ch. M a r k w a l d e r 9 G. G s t r e i n Seltene Forro einer cerebralen Embolie nach Karotistrauma Eingegangen: 24. Juni 1996 / Angenommen: 15. Juli 1996 A r a r e case of c e r e b r a l e m b o l i s m d u e to a b l u n t t r a u m a of t h e c a r o t i d a r t e r y A b s t r a c t A 66-year-old m a n was involved in a struggle with a younger man. During the fight the younger m a n grabbed the victim around the neck and hit his head several times against the floor. A few minutes later the victim became hemiparetic, aphasic and later unconscious. He was taken to hospital where he died 2 months later from urosepsis. The autopsy revealed a detached arteriosclerotic plaque of the left carotid artery and an infarction of parts of the left hemisphere. The left cerebral medial artery was blocked by a sequestrum of the calcified carotid intima. A direct causal connection between the trauma and death could be shown. K e y w o r d s Carotid artery -E m b o l i s m 9 T r a u m a -Arteriosclerosis

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Comments on the Aetiology of Indirect Traumatic Thrombosis of the Internal Carotid

Abstract: A group of 22 patients with internal carotid thrombosis following head injuries, admitted to hospital during the last decade is discussed, particularly as regards the relationship between trauma and thrombosis seen from the aetiological, diagnostic and medico-legal aspects.

Cited by 6 publications

References 0 publications

Diagnostic and Therapeutic Management of Bilateral Carotid Artery Occlusion Caused by Near-Suicidal Hanging

Diagnostic and Therapeutic Management of Bilateral Carotid Artery Occlusion Caused by Near-Suicidal Hanging

Malignant Cerebral Infarction Secondary to Internal Carotid Injury in Closed Head Trauma: Good Outcome with Aggressive Treatment

Seltene Form einer cerebralen Embolie nach Karotistrauma

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