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https://www.readbyqxmd.com/read/29147634/intracranial-ischemic-infarct-due-to-blunt-force-trauma-in-a-high-school-football-player
#1
Brandon I Esianor, Ali S Haider, Margaret I Engelhardt, Tijani Osumah, Steven Vayalumkal, Richa Thakur, Dean Leonard, Jeffrey Haithcock, Kennith F Layton
Ischemic stroke is an uncommon cause of death among teenagers and young adults; however, the etiologies differ when compared to ischemic strokes in older individuals. Large-vessel atherosclerosis and small-vessel disease causing ischemic stroke are rare for the teenage population, while cervicocerebral arterial dissections account for up to 20% of ischemic strokes. Here, we present the case of a 16-year-old male who developed internal carotid artery dissection (ICAD) after a head injury and subsequently developed ischemic stroke and seizures...
September 7, 2017: Curēus
https://www.readbyqxmd.com/read/29142582/pseudoaneurysm-of-left-proximal-common-carotid-artery-following-penetrating-trauma
#2
Rehana Shaikh, Saba Sohail, Parvez Ahmed Shaikh, Qamar-Un-Nisa Nisa
A 33-year male with history of penetrating trauma to left upper chest in 2006, presented through Medical unit to Radiology Department with complain of hemoptysis. Chest X-ray showed a soft tissue lesion in left upper lobe with a linear metallic foreign body. Contrast enhanced CT scan of chest and later CTA was performed which showed a saccular aneurysm arising from mediastinal part of left common aortic artery surrounded by thrombosis with a cylindrical linear metallic foreign body. He was planned for endovascular repair with stenting which he could not afford due to financial constraints...
September 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29137056/optic-nerve-injury-associated-blunt-cerebrovascular-injury-three-case-reports
#3
Dan-Dong Li, Liu-Xun Hu, Linyuan Sima, Shang-Yu Xu, Jian Lin, Nu Zhang, Bo Yin
RATIONALE: Blunt cerebrovascular injury (BCVI) is a rare complication that may occur after craniocervical trauma. The current literature is limited to extracranial carotid artery injuries; however, no reports have been published on blunt intracranial carotid injury (BICI), especially those associated with optic nerve injury. PATIENT CONCERNS: Here we report on 3 BICI cases that demonstrated optic nerve injuries after craniofacial injuries. All 3 patients showed post-trauma vision loss on the injured side...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29034244/contemporary-strategies-in-the-management-of-civilian-neck-zone-ii-vascular-trauma
#4
REVIEW
Georgios Karaolanis, Konstantinos Maltezos, Chris Bakoyiannis, Sotiris Georgopoulos
Neck trauma is the leading cause of death mainly in younger persons posing to surgeons the dilemma whether to proceed with reconstruction of vascular injuries either in the presence of coma or in severe neurological deficit. Vascular injuries in zone II predominate over the other injuries located in zones I/III of the neck. Conventional open repair of carotid injuries with primary closure or interposition grafting is always recommended due to the effective long-term results for penetrating injuries or for patients unfit for endovascular intervention...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28922275/indications-for-ct-angiography-of-the-vertebral-arteries-after-trauma
#5
Joseph P Drain, Douglas S Weinberg, James S Ramey, Timothy A Moore, Heather A Vallier
STUDY DESIGN: Retrospective. OBJECTIVE: The purpose of this project is to identify factors that predict vertebral artery injury (VAI) in an effort to assess risks and benefits of computed tomography angiography (CT-A) of the neck in the trauma setting. We seek to develop guidelines for practitioners to stratify patients at medium/high risk of VAI from those who are at low risk. SUMMARY OF BACKGROUND DATA: VAI and blunt carotid injury (BCI) together comprise blunt cerebrovascular injury (BCVI)...
September 15, 2017: Spine
https://www.readbyqxmd.com/read/28877048/current-opinion-in-otolaryngology-update-on-vascular-injuries-in-craniomaxillofacial-fractures
#6
Elisa Illing, Sarah Jo Burgin, Cecelia E Schmalbach
PURPOSE OF REVIEW: The primary purpose of this chapter is to define current recommendations for vascular work-up of patients with craniomaxillofacial (CMF) trauma with emphasis on imaging to include intraoperative fluorescence, angiography, and surgical exploration. The second goal is to review current management recommendations for observation versus surgical exploration based on the neck zones of injury. RECENT FINDINGS: Over the past two decades, endovascular techniques are increasingly utilized, particularly in zones I and III of the neck...
December 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28799874/limitations-of-multidetector-computed-tomography-angiography-for-the-diagnosis-of-blunt-cerebrovascular-injury
#7
Ramesh Grandhi, Gregory M Weiner, Nitin Agarwal, David M Panczykowski, William J Ares, Jesse S Rodriguez, Jonathan A Gelfond, John G Myers, Louis H Alarcon, David O Okonkwo, Brian T Jankowitz
OBJECTIVE Blunt cerebrovascular injuries (BCVIs) following trauma carry risk for morbidity and mortality. Since patients with BCVI are often asymptomatic at presentation and neurological sequelae often occur within 72 hours, timely diagnosis is essential. Multidetector CT angiography (CTA) has been shown to be a noninvasive, cost-effective, reliable means of screening; however, the false-positive rate of CTA in diagnosing patients with BCVI represents a key drawback. Therefore, the authors assessed the role of DSA in the screening of BCVI when utilizing CTA as the initial screening modality...
August 11, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28666040/internal-carotid-artery-dissection-after-indirect-blunt-cervical-trauma-in-an-ice-hockey-goaltender
#8
Ryan M Degen, Matthew E Fink, Lisa Callahan, Kenton Fibel, Jim Ramsay, Bryan T Kelly
Internal carotid artery dissections are rare injuries that can result from both direct cervical trauma and indirect trauma causing sudden cervical hyperextension. Depending on the magnitude of the dissection, clinical presentation ranges from neurologic symptoms, such as Horner syndrome, to relatively mild but persistent headache symptoms, as in the case reported in this article. High clinical suspicion with subsequent neuroimaging is recommended in similar clinical scenarios. Our patient, an ice hockey goaltender, was conservatively treated with rest and serial neuroimaging studies to ensure resolution of the dissection...
May 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28664025/traumatic-carotid-cavernous-fistula-with-a-connection-between-the-supraclinoid-internal-carotid-artery-and-cavernous-sinus-via-a-pseudoaneurysm-presenting-with-delayed-life-threatening-epistaxis
#9
Jun Kyeung Ko, Sang Weon Lee, Tae Hong Lee, Chang Hwa Choi
Traumatic carotid cavernous fistula (CCF) presents most commonly as a direct connection between the cavernous segment of internal carotid artery (ICA) and cavernous sinus (CS), and often accompanies basal skull fracture (BSF). The most frequently reported signs and symptoms are proptosis, chemosis, and bruit. Epistaxis is uncommon symptom of CCF. A 63-year-old man with a history of BSF due to blunt head trauma eight months previously was referred to our emergency room for massive epistaxis. Cerebral angiography demonstrated a high-flow CCF with a connection between the supraclinoid portion of left ICA and CS via a pseudoaneurysm, suggesting the life-threatening epistaxis had been caused by high-flow shunting, through the gap created by the BSF...
April 2017: NMC Case Rep J
https://www.readbyqxmd.com/read/28658027/transcranial-doppler-microemboli-monitoring-for-stroke-risk-stratification-in-blunt-cerebrovascular-injury
#10
Robert H Bonow, Cordelie E Witt, Bryan P Mosher, Mahmud Mossa-Basha, Monica S Vavilala, Frederick P Rivara, Joseph Cuschieri, Saman Arbabi, Randall M Chesnut
OBJECTIVES: To assess whether microemboli burden, assessed noninvasively by bedside transcranial Doppler ultrasonography, correlates with risk of subsequent stroke greater than 24 hours after hospital arrival among patients with blunt cerebrovascular injury. The greater than 24-hour time frame provides a window for transcranial Doppler examinations and therapeutic interventions to prevent stroke. DESIGN: Retrospective cohort study. SETTING: Level I trauma center...
October 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28654057/murine-aortic-crush-injury-an-efficient-in-vivo-model-of-smooth-muscle-cell-proliferation-and-endothelial-function
#11
Dan Yu, George Makkar, Rajabrata Sarkar, Dudley K Strickland, Thomas S Monahan
Arterial reconstruction, whether angioplasty or bypass surgery, involves iatrogenic trauma causing endothelial disruption and vascular smooth muscle cell (VSMC) proliferation. Common murine models study small vessels such as the carotid and femoral arteries. Herein we describe an in vivo system in which both VSMC proliferation and endothelial barrier function can be simultaneously assessed in a large vessel. We studied the infrarenal aortic response to injury in C57BL/6 mice. The aorta was injured from the left renal vein to the aortic bifurcation by 30 transmural crushes of 5-seconds duration with a cotton-tipped applicator...
June 11, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28647095/increased-detection-of-blunt-carotid-and-vertebral-artery-injury-after-implementation-of-diagnostic-imaging-pathway-in-level-1-trauma-centre-in-western-australia
#12
Manimaran Sinnathamby, Sudhakar V Rao, Dieter G Weber
BACKGROUND: The incidence of Blunt Carotid Artery and Vertebral Artery Injury (BCVI) is relatively low in modern trauma practice. However, these injuries may be associated with severe neurological consequences. Following the introduction of a Diagnostic Imaging Pathway in Department of Health of Western Australia, we hypothesized that this injury would be less likely to be missed, and accordingly diagnosed more frequently. METHOD: A review of all major trauma (Injury Severity Scale>15) admissions at the State Major Trauma Centre in Royal Perth Hospital was undertaken from 1995 until 2013...
September 2017: Injury
https://www.readbyqxmd.com/read/28640778/a-cohort-study-of-blunt-cerebrovascular-injury-screening-in-children-are-they-just-little-adults
#13
Mackenzie R Cook, Cordelie E Witt, Robert H Bonow, Eileen M Bulger, Ken F Linnau, Saman Arbabi, Bryce R H Robinson, Joseph Cuschieri
BACKGROUND: Blunt cerebrovascular injuries (BCVI) are rare with nonspecific predictors, making optimal screening critical. Radiation concerns magnify these issues in children. The Eastern Association for the Surgery of Trauma (EAST) criteria, the Utah score (US) and the Denver criteria (DC) have been advocated for pediatric BCVI screening, though direct comparison is lacking. We hypothesized that current screening guidelines inaccurately identify pediatric BCVI. METHODS: This was a retrospective cohort study of pediatric trauma patients treated from 2005-2015 with radiographically confirmed BCVI...
June 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28576125/dissection-of-the-internal-carotid-artery-and-stroke-after-mandibular-fractures-a-case-report-and-review-of-the-literature
#14
Ingrid Aune Tveita, Martin Ragnar Skjerve Madsen, Erik Waage Nielsen
BACKGROUND: We present a report of a patient with blunt trauma and mandibular fractures who developed a significant cerebral infarction due to an initially unrecognized injury of her left internal carotid artery. We believe that increased knowledge of this association will facilitate early recognition and hence prevention of a devastating outcome. CASE PRESENTATION: A 41-year-old ethnic Norwegian woman presented to our Emergency Room after a bicycle accident that had caused a direct blow to her chin...
June 2, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28525467/analysis-of-cervical-angiograms-in-cervical-spine-trauma-patients-does-it-make-a-difference
#15
Tina Dreger, Howard Place, Theresa Mattingly, Christine Piper, Jennifer Brechbuehler
STUDY DESIGN: Retrospective review. OBJECTIVE: To evaluate computed tomography angiogram (CTA) use for diagnosing blunt vertebral artery injury (BVAI) at a single institution, to assess the incidence of BVAI in the studied population, and determine if diagnosis affected care. We also wanted to evaluate if testing and treatment resulted in complications. SUMMARY OF BACKGROUND DATA: BVAI is an example of a previously underdiagnosed injury. Ease of CTA has simplified vertebral artery evaluation...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28499862/successful-revascularization-of-aortic-arch-in-a-39-year-old-blunt-trauma-patient-with-acute-diffuse-axonal-injury-without-the-use-of-systemic-anticoagulation
#16
Andrew M Abi-Chaker, Keith M Jones, Priscilla Sanchez, Jordan Sasson, Xiaoyi Li, Jorge Rey
Blunt traumatic aortic injury is the second leading cause of death in trauma patients aged 4-34 years. Of the patients who are able to receive treatment, mortality rates as high as 40% have been reported. Endovascular repair options have allowed for more expeditious repairs with reduced iatrogenic trauma; however, when the injury involves the ascending aorta or arch, current endografts lack fenestrations needed for cerebral blood flow. Traditionally, on pump, cardiopulmonary bypass with systemic anticoagulation has been used to repair these injuries...
May 10, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28485656/delayed-massive-epistaxis-from-traumatic-cavernous-carotid-false-aneurysms-a-report-of-two-unusual-cases
#17
Ncedile Mankahla, David LeFeuvre, Allan Taylor
Introduction Blunt head trauma can injure the cavernous segment of the internal carotid artery (ICA). This may result in a carotid cavernous fistula (CCF). Rarely, a traumatic aneurysm may bleed medially causing massive epistaxis. Case presentation We present two cases of traumatic intracavernous carotid pseudoaneurysms with delayed massive epistaxis. The patients were managed with endovascular treatment involving coil embolization with parent vessel sparing and detachable balloon occlusion with carotid sacrifice...
August 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28475705/management-of-penetrating-cerebrovascular-injuries-in-pediatric-trauma-a-retrospective-multicenter-study
#18
Vijay M Ravindra, Michael C Dewan, Hassan Akbari, Robert J Bollo, David Limbrick, Andrew Jea, Robert P Naftel, Jay K Riva-Cambrin
BACKGROUND: Blunt cerebrovascular injury is uncommon in the pediatric population; penetrating cerebrovascular injuries are even rarer and are thus poorly understood. OBJECTIVE: To describe the diagnosis and management of penetrating cerebrovascular injuries and describe outcomes of available treatment modalities. METHODS: Clinical and radiographic data were collected retrospectively from a multicenter trauma registry for children screened for cerebrovascular injury during 2003 to 2013 at 4 academic pediatric trauma centers...
September 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28399527/blunt-traumatic-extracranial-cerebrovascular-injury-and-ischemic-stroke
#19
Paul M Foreman, Mark R Harrigan
BACKGROUND: Ischemic stroke occurs in a significant subset of patients with blunt traumatic cerebrovascular injury (TCVI). The patients are victims of motor vehicle crashes, assaults or other high-energy collisions, and suffer ischemic stroke due to injury to the extracranial carotid or vertebral arteries. SUMMARY: An increasing number of patients with TCVI are being identified, largely because of the expanding use of computed tomography angiography for screening patients with blunt trauma...
2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28280639/delayed-stroke-following-blunt-neck-trauma-a-case-illustration-with-recommendations-for-diagnosis-and-treatment
#20
Best Anyama, Daniela Treitl, Jeffery Wessell, Rachele Solomon, Andrew A Rosenthal
Blunt cerebrovascular injury (BCVI) to the carotid artery is a relatively rare injury that is difficult to identify even with imaging. Any symptoms or neurological deficits following blunt neck injury mandate evaluation and consideration of BCVI. In an effort to highlight this issue, we report the case of a 31-year-old male patient who presented with left-sided weakness consistent with transient ischemic attack (TIA) and concussion. The patient's symptoms occurred within 24 hours of a blunt neck injury sustained by a knee strike during a basketball game...
2017: Case Reports in Emergency Medicine
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