Flapping of the dissected intima in a case of traumatic carotid artery dissection in a jackhammer worker

Vadikolias, Κonstantinos; Heliopoulos, John; Serdari, Aspasia; Vadikolia, Chrissanthi M.; Piperidou, Charitomeni

doi:10.1002/jcu.20556

Cited by 8 publications

(5 citation statements)

References 11 publications

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“…Their patient developed headache and visual disturbances days after riding a mountain bicycle despite not having any accidents or falling off the bike. Vadikolias et al presented the case of a man who developed ICAD after intense jackhammer use (several hours) in a horizontal position [ 82 ].…”

Section: Resultsmentioning

confidence: 99%

“…76 [80][81][82][83][84][89][90][91] Not specified 22 [88,99,100,103] Gunshot 3 [68,86,87] Penetrating injuries Stab wound 2 27 [86,101] Horse-riding fall 3 [46,59,60] Football 4 [24,25,76] Snowboarding 1 [75] Water-skiing/ wakeboarding 2 [25,77] Skydiving 1 [25] Basketball 1 [7] Softball 3 [73,74] Taekwondo 1 [79] CrossFit 1 [72] Bungee jumping 1 [78] Sport (with or without specific blunt trauma)…”

Section: Head or Neck Blunt Injuriesmentioning

confidence: 99%

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Traumatic Internal Carotid Artery Injuries: Do We Need a Screening Strategy? Literature Review, Case Report, and Forensic Evaluation

Maiese

Frati

Manetti

et al. 2022

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: Internal carotid artery dissection (ICAD) represents the cause of ictus cerebral in about 20% of all cases of cerebral infarction among the young adult population. ICAD could involve both the extracranial and intracranial internal carotid artery (ICA). It could be spontaneous (SICAD) or traumatic (TICAD). It has been estimated that carotid injuries could complicate the 0,32% of cases of general blunt trauma and the percentage seems to be higher in severe multiple traumas. TICAD is diagnosed when neurological symptoms have already occurred, and it could have devastating consequences, from permanent neurological impairment to death. Thus, even if it is a rare condition, a prompt diagnosis is essential. There are no specific guidelines regarding TICAD screening. TICAD is mainly correlated to motor vehicle accidents (94/227), specifically to car accidents (39/94), and to direct or indirect head and cervical trauma (76/227). Nevertheless, TICAD should be considered when a young adult or middle-aged patient presents after severe blunt trauma. Understanding which kind of traumatic event is most associated with TICAD could help clinicians direct their diagnostic process. Herein, a review of the literature concerning TICAD has been carried out to highlights its correlation with specific traumatic events. As well, a case report is presented to discuss TICAD forensic implications.

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Section: Resultsmentioning

confidence: 99%

Section: Head or Neck Blunt Injuriesmentioning

confidence: 99%

Traumatic Internal Carotid Artery Injuries: Do We Need a Screening Strategy? Literature Review, Case Report, and Forensic Evaluation

Maiese

Frati

Manetti

et al. 2022

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“…Cervical artery dissection(CAD) is the most common cause of ischemic stroke in young people. Dissection occurs when the intima or the media of the arterial wall is disrupted, causing an intramural hematoma in the subintimal, in the medial, or in the subadventitial layers [4]. Stroke in CAD is a consequence either of embolism originating from the injured intima or of hemodynamic compromise [5].…”

Section: Discussionmentioning

confidence: 99%

Cervical artery dissection—an easily neglected cause of stroke: a case report

et al. 2020

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Background In recent years, the incidence of stroke has gradually increased in young people. There are many reasons causing stroke, including atherosclerosis, artery embolization, and cervical artery dissection and so on. However, cervical artery dissection is a major cause of stroke in young people. We present a case of ischemic stroke caused by dissection, whose distal vascular occlusion due to detachment of the thrombosis in the right internal carotid artery. Case presentation A 33-year-old male patient was admitted to the hospital because of stroke. Imaging examination showed that there was no visualization of the right middle cerebral artery and there were a large number of mural thrombus in the C1 segment of the right internal carotid artery. After emergency surgery, the patient had vascular recanalization and the symptoms were significantly improved. Magnetic resonance imaging showed a high signal in the C1 segment of the right internal carotid artery, the abnormal signal disappeared after antiplatelet therapy. Conclusions When a patient has symptoms of stroke, we need to explore the root cause of stroke. Especially in young people, cervical artery dissection is an important reason that can’t be ignored. Through review and analysis of this case, we hope to improve the understanding of radiologists and clinicians about the cervical artery dissection, reduce the rate of misdiagnosis, and improve patients’ prognosis.

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“…Innominate dissections, with or without innominate rupture, can be spontaneous [13] or secondary to trauma [14,15], heritable connective tissue disorders like Ehlers- Danlos syndrome [16,17], iatrogenic, for example, after axillary perfusion during arch surgery [18], or following aortic dissections [19]. Aortic dissection involves carotid arteries in 28%, celiac, mesenteric or renal arteries in 28%, iliac or femoral arteries in 26%, subclavian arteries in 14%, coronary arteries in 7% and spinal arteries in 1.8% [20].…”

Section: Discussionmentioning

confidence: 99%

Innominate truncal and arch blowout with left hemiparesis and right hemothorax followed by delayed cheese-wire perforation of innominate graft

Kaul

Paniagua

2013

J Cardiothorac Surg

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We present the case of a 68 year old Caucasian woman, in extremis, with left hemiparesis and right hemothorax, in hypovolemic shock, secondary to a blow-out of a large penetrating ulcer at the junction of innominate trunk and aortic arch. She underwent interposition graft replacement of innominate trunk and repair of aortic arch, on cardiopulmonary bypass, employing total circulatory arrest and selective antegrade cerebral perfusion and had total resolution of hemiparesis. She, however, represented, 6 months later, with threatened exsanguination after a sternal wire cheese-wired through the sternum and perforated the anteriorly lying innominate graft. Following successful repair, she was found to have an old intramural hematoma of distal arch and descending thoracic aorta and changes suggestive of chronic dissection of the whole of abdominal aorta. This was managed conservatively.We believe this patient’s presentation initially with a spontaneous innominate blow-out, cardiogenic shock, hemothorax and hemiparesis, and later with cheese-wire perforation of the innominate graft is unique. Her surgical rescue at both presentations was equally unusual, and without surgical precedent to the best of our knowledge. Was the initial innominate blow-out the result of localised innominate dissection, or more unusually, part of retrograde descending thoracic dissection with skip penetration of innominate artery and sparing of the intervening arch? Was it secondary to the minor fall she had sustained 1 week prior to the event, resulting in a false aneurysm or a contained hematoma next to the innominate artery? More intriguingly, did diffuse aortopathy underpin these diverse etiologies and result in penetrating intimal ulcer with blow out in the innominate artery, intramural hematoma in the arch and descending thoracic aorta and dissection in abdominal aorta at different points in time?We review the current literature for these unusual afflictions of innominate trunk and its origin from the arch of aorta.

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Flapping of the dissected intima in a case of traumatic carotid artery dissection in a jackhammer worker

Cited by 8 publications

References 11 publications

Traumatic Internal Carotid Artery Injuries: Do We Need a Screening Strategy? Literature Review, Case Report, and Forensic Evaluation

Traumatic Internal Carotid Artery Injuries: Do We Need a Screening Strategy? Literature Review, Case Report, and Forensic Evaluation

Cervical artery dissection—an easily neglected cause of stroke: a case report

Innominate truncal and arch blowout with left hemiparesis and right hemothorax followed by delayed cheese-wire perforation of innominate graft

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