Management of Blunt Injury to the Internal Carotid Artery

Welling, Richard E.; Saul, Thomas G.; Tew, John M.; Tomsick, Thomas A.; Kremchek, Timothy E.; Bellamy, Mary Jane

doi:10.1097/00005373-198711000-00005

Cited by 53 publications

(16 citation statements)

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“…[12][13][14][15][16] The patient's presenting symptom of cerebral ischemia may reveal the underlying cerebrovascular injury. Carotid artery injuries generally result in contralateral sensorimotor deficits, while VAIs typically manifest as ataxia, dizziness, vomiting, facial or body analgesia, or visual field defects.…”

Section: Historical Perspectivementioning

confidence: 99%

“…12 The most common mechanism causing CAI is hyperextension resulting from the stretching of the carotid artery over the lateral articular processes of C1-C3. [13][14][15][16][17][18] Vertebral artery injuries are likely a combination of direct injury, due to associated fractures of the vertebrae involving the transverse foramen through which the artery courses, and hyperextension-stretch injury due to the tethering of the vertebral artery within the lateral masses of the cervical spine. Regardless of mechanism, there is intimal disruption of the carotid or vertebral artery.…”

Section: Historical Perspectivementioning

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: Historical Perspectivementioning

confidence: 99%

Section: Historical Perspectivementioning

confidence: 99%

Blunt Cerebrovascular Injuries

Cothren¹,

Moore²

2008

Current Therapy of Trauma and Surgical Critical Care

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“…Complete arterial disruption resulting from blunt inju ry generally occurs at the skull base and has a uniformly dismal prognosis with death occurring quickly from naso pharyngeal hemorrhage [6,7], Pseudoaneurysms have been successfully managed, depending upon location, by excision/repair, ligation with or without bypass, and/or anticoagulation [6,8,9]. Carotid-cavernous fistulae are treated with great success using endovascular techniques [8].…”

Section: Discussionmentioning

confidence: 99%

“…Carotid-cavernous fistulae are treated with great success using endovascular techniques [8]. In most series arterial dissection and/or thrombosis make up the majority of cases of BCI.…”

Section: Discussionmentioning

confidence: 99%

Blunt Carotid Injury in Children

Duke¹,

Partington²

1996

Pediatr Neurosurg

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Blunt carotid injury (BCI) is a rare entity which can have devastating neurologic consequences. Little has been reported on the mechanism of injury, presentation or management of these injuries in children. We present a series of 5 children with BCI. One patient died at presentation while the remainder developed delayed infarctions. Three surviving patients developed intracranial hypertension and required intracranial pressure (ICP) monitoring. Surgical resection of infarcted tissue was required to control ICP in 2 patients. All four surviving patients are impaired but ambulatory. We propose an aggressive management strategy for BCI aimed at early detection of deficit, early angiography, anticoagulation if appropriate, and active management of ischemia including hemodynamic treatment, ICP monitoring, and active use of medical and surgical means to monitor and control intracranial hypertension.

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“…As awareness of blunt carotid and vertebral arterial injuries has increased, many centers have adopted aggressive imaging screening protocols in selected patients, which has led to a rise in the reporting of this type of injury. [10][11][12][13][14][15][16][17][18][19][20] Biffl and associates 20 reported an incidence of blunt ca-the media or adventitia. Subintimal hemorrhages tend to cause luminal narrowing, whereas subadventitial hemorrhages are more likely to result in aneurysmal dilatation of the artery and pseudoaneurysm formation.…”

mentioning

confidence: 99%

Emergency Evaluation and Treatment of Injury to the Extracranial Carotid and Vertebral Arteries

Stallmeyer¹,

Zoarski²,

Gittleman³

et al. 2003

Semin intervent Radiol

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This article describes the evaluation and treatment of injuries to the carotid and vertebral arteries. The diagnosis of the injured vessels by clinical and imaging methods is described. A variety of treatments including the use of stents is given. KEYWORDS:Trauma, vertebral artery, carotid artery rotid injury of 1.11% among patients admitted with blunt trauma. Another study 21 identified 67 patients with 87 blunt carotid injuries over a period of 11 years, for a rate of 0.67% where motor vehicle collision was the mechanism of injury and a rate of 0.33% for other blunt trauma. Prall and colleagues 16 found an incidence of 3.5% when carotid arteriography was performed in patients undergoing aortogram for blunt traumatic injury. The corresponding reported incidence of vertebral artery injury due to blunt trauma is 0. 77%. 11,20 Downloaded by: Collections and Technical Services Department. Copyrighted material.

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Management of Blunt Injury to the Internal Carotid Artery

Cited by 53 publications

References 0 publications

Blunt Cerebrovascular Injuries

Blunt Cerebrovascular Injuries

Blunt Carotid Injury in Children

Emergency Evaluation and Treatment of Injury to the Extracranial Carotid and Vertebral Arteries

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