The Management of Blunt Injury to the Internal Carotid Artery

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

doi:10.1097/00005373-198607000-00082

Cited by 3 publications

(8 citation statements)

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“…1,4,6, Our patient presented 8 weeks after his injury, whereas seven (16%) patients presented within 1 week of trauma, and the mean time to diagnosis was 12 months. 1,4,6, Of the 42 cases reviewed, 5 patients (12%) were accurately diagnosed with PTCP using CT or magnetic resonance angiography, 3 cases (7%) were identified using chest radiography, and 13 patients (31%) were diagnosed by duplex ultrasonography. In the remaining cases, the diagnosis was made during arteriography performed for a variety of indications, including the mechanism of injury, anatomic location of neck trauma, or presence of neurologic symptoms.…”

Section: Discussionmentioning

confidence: 85%

“…Twenty-five patients (59%) had pseudoaneurysms localized in zone I or III of the neck, and the remaining patients either had zone II lesions or this description was unlisted. 1,4,6, Our patient was diagnosed by duplex ultrasonography and had a PTCP localized to zone II of the neck. Although duplex ultrasonography is useful in the initial evaluation of lesions involving the carotid artery, CT angiography can more accurately assess the size of the aneurysm, precise location of the lesion, presence of thrombus, and relationship of the lesion to surrounding structures.…”

Section: Discussionmentioning

confidence: 89%

“…[1][2][3] Traumatic carotid artery injury is associated with a mortality of up to 40%, with up to 45% of survivors having residual neurologic deficits. 4 In the setting of trauma, carotid artery injury can lead to carotid dissection, laceration, occlusion, arteriovenous fistula, and pseudoaneurysm formation.…”

Section: Discussionmentioning

confidence: 99%

“…4 In the setting of trauma, carotid artery injury can lead to carotid dissection, laceration, occlusion, arteriovenous fistula, and pseudoaneurysm formation. [1][2][3][4][5] Carotid pseudoaneurysms are rare and comprise less than 20% of reported cases of extracranial carotid aneurysms in the world literature. 6,7 In addition to trauma, they can occur as complications of carotid dissection or carotid surgical procedures such as carotid endarterectomy or from iatrogenic carotid injury.…”

Section: Discussionmentioning

confidence: 99%

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Diagnosis and Management of Traumatic Pseudoaneurysm of the Carotid Artery: Case Report and Review of the Literature

et al. 2008

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Diagnosis and Management of Traumatic Pseudoaneurysm of the Carotid Artery: Case Report and Review of the Literature

et al. 2008

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“…9,10 Common symptoms in traumatic ICA injury include hemicrania, Horner's syndrome, paralysis, unilateral facial weakness, hemianesthesia, aphasia, amaurosis fugax, or seizure. 10 Traumatic ICA injury should be suspected in any alert patients with posttraumatic hemiparesis, because other insults that can cause hemiparesis are often associated with marked obtudation. 11 ICA injuries are diagnosed after the development of an unexpected neurologic deficit.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of Traumatic Internal Carotid Artery Injury

Yang

Liao

et al. 2007

Journal of Craniofacial Surgery

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Optimally, internal carotid artery (ICA) injury associated with craniofacial trauma should be treated soon after diagnosis. However, diagnosis is difficult and often delayed. The typical symptoms and signs for diagnosis of traumatic ICA injuries are sometimes easily neglected. Clinically, some patients were initially diagnosed by craniofacial fracture nearby the course of ICA. This investigation retrospectively reviews clinical experience in patients with traumatic ICA injury with a focus on the importance of craniofacial fracture nearby the course of ICA observed on brain or facial bone computed tomography. Eighteen patients with traumatic ICA injury were diagnosed at Chang Gung Memorial Hospital, Taiwan, from June 1998 to April 2004, including 10 patients with pseudoaneurysm formation, seven patients with occlusion, and one patient with laceration. Brain or facial bone computed tomography was reviewed retrospectively. The sample included 14 (78%) patients with skull base fractures involving the intracranial course of ICA and three (17%) patients with mandibular and cervical spine fractures near the course of extracranial ICA. Only one (5%) patient did not have evident fracture. Fractures involving the carotid canal were noted in three (17%) patients. Eight patients received interventional treatments. No further interventional treatments for traumatic ICA occlusion were performed as a result of good collateral flow from contralateral ICA or large infarction noted when diagnosed. Three patients with pseudoaneurysm received expectant management. One patient with arterial laceration with extravasation received no further management. Through meticulously evaluating routine brain and facial bone computed tomography, craniofacial fracture involving intracranial or extracranial course of ICA may be an adjuvant indicator of traumatic ICA injury for early diagnosis.

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