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https://www.readbyqxmd.com/read/28727357/-spontaneous-carotid-and-vertebral-dissections
#1
Roman Sztajzel, Fabienne Perren, Patrik Michel
Dissections of the cervical arteries account for approximately 15-20 % of all strokes in young patients. Clinically they present with laterocervical and/or hemicranial pain associated to a Horner syndrome in case of carotid dissection and a posterior cervical pain associated to headache in the occipital area in case of vertebral dissection. A multifactorial origin is often suggested, resulting from the combination of a weakness of the arterial wall, hereditary or not, of environmental factors such minor trauma or a previous infection and also of the presence of a certain number of vascular risk factors such as high blood pressure or migraines...
April 26, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28676385/syncope-workup-greater-yield-in-select-trauma-population
#2
Melike Harfouche, Michael Cline, Michael Mazzei, Thomas Santora
BACKGROUND: There is great variation in practice regarding the assessment of trauma patients who present with syncope. The purpose of this study was to determine the yield of screening studies (electrocardiogram, echocardiogram, and carotid duplex) and define characteristics to identify groups that may benefit from these investigations. METHODS: We conducted a retrospective cohort study of all trauma patients from 2003 to 2015 who received a carotid duplex as part of a syncope evaluation at our urban Level 1 Trauma Center...
July 1, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28666040/internal-carotid-artery-dissection-after-indirect-blunt-cervical-trauma-in-an-ice-hockey-goaltender
#3
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
#4
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
#5
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...
June 24, 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
#6
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/28649221/notch-1-mutation-in-a-patient-with-spontaneous-and-recurrent-dissections-of-extracranial-arteries
#7
Carlos Guevara, Gonzalo Farias, Kateryna Bulatova, Pablo Alarcón, Wendy Soruco, Carlos Robles, Marcelo Morales
Dissections of extracranial arteries are estimated to account for only 2% of all ischemic strokes but for approximately 20% of strokes in patients younger than 45 years old. Most dissections of extracranial arteries involve some trauma stretch, mechanical stress, or connective tissue abnormalities. In the absence of these disorders, determining the etiology of recurrent extracranial dissections is quite challenging because the underlying nature of these cases is poorly understood. We report the case of a 44-year-old female with recurrent dissections of the vertebral and carotid arteries associated with a heterozygous mutation p...
2017: Frontiers in Neurology
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
#8
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...
June 13, 2017: Injury
https://www.readbyqxmd.com/read/28640778/a-cohort-study-of-blunt-cerebrovascular-injury-screening-in-children-are-they-just-little-adults
#9
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/28634313/-a-case-of-bilateral-traumatic-carotid-cavernous-fistula
#10
Hanae Terashima, Takashi Higa, Koichi Kato, Tadasuke Tominaga, Masanori Nakagawa, Shigeru Kadoyama, Hiroshi Ujiie, Akira Teramoto
Bilateral traumatic carotid-cavernous fistula(CCF)is rare. It is most commonly caused by a direct head or face injury involving the cavernous sinus and develops immediately after trauma. We report a case of bilateral traumatic CCF that occurred as an intracerebral hematoma(ICH)mimicking apoplexy 5 months later. We treated the patient with point occlusion of venous reflux causing an ICH using coil embolization to remove the hematoma. Three days after we performed trans-venous occlusion of the intercavernous connection and right cavernous sinus using coil embolization through the right inferior petrosal vein, it was identified that the left CCF was occluded after first embolization into the left sylvian vein...
June 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28580223/carotid-cavernous-fistula-with-central-retinal-artery-occlusion-and-terson-syndrome-after-mid-facial-trauma
#11
Satya Karna, Mukesh Jain, Md Shahid Alam, Bipasha Mukherjee, Rajiv Raman
Objectives: To report a rare occurrence combination of central retinal artery occlusion (CRAO) and Terson syndrome in a Barrow's type A carotid cavernous fistula (CCF) patient. Methods: Observational case report. Results: A twenty-year-old male patient with a history of road traffic accident presented with periorbital swelling and redness in the left eye. Examination revealed a CRAO with intraretinal and preretinal hemorrhages. On imaging, type A CCF and subarachnoid hemorrhage were detected. He underwent embolization of the fistula for cosmetic blemish...
2017: GMS Ophthalmology Cases
https://www.readbyqxmd.com/read/28576528/endovascular-management-of-iatrogenic-cervical-internal-carotid-artery-pseudoaneurysm-in-a-9-year-old-child-case-report-and-literature-review
#12
REVIEW
Martín Pinzón, Nelson Oswaldo Lobelo, María Claudia Rodríguez, Perla Villamor, Ana María Otoya
Extracranial internal carotid artery (ICA) pseudoaneurysms are uncommon in the pediatric population and are usually secondary to direct trauma to the vessel. Treatment options include surgery (ligation), anticoagulation therapy and endovascular treatment. Endovascular covered stents have shown good results in adult populations, resulting in occlusion of the aneurysm and preservation of the artery without significant complications. However, there have been only limited reports in the literature reporting endovascular carotid stent placement in the pediatric population...
April 2017: International Journal of Pediatric Otorhinolaryngology
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
#13
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
#14
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
#15
Andrew M Abi-Chaker, Keith M Jones, Priscilla Sanchez, Jordan Sasson, Xiaoyi Li, Jorge Rey
BACKGROUND: Blunt traumatic aortic injury is the second leading cause of death in trauma patients age 4 to 34. Of the patients that 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 9, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28497668/potential-brain-dead-organ-donation-in-neurocritical-care-mortality
#16
Vera Spatenkova, Ondrej Bradac, Petr Suchomel
BACKGROUND: Mortality is a marker of quality in neurocritical care, but it also provides potential for donors after brain death (DBD) following irreversible acute brain damage. The aim of this study was to analyse the neurointensive care unit (NICU) mortality rate and recovery of potential DBD. METHODS: We performed a 10-year prospective observational cohort computer database analysis of 6138 acute neurological and neurosurgical patients (pts, 58.2% male, mean: age 55...
May 11, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28491191/internal-carotid-artery-dissection-and-pseudoaneurysm-formation-with-resultant-ipsilateral-hypoglossal-nerve-palsy
#17
Giuseppe Cruciata, Rikesh Parikh, Meera Pradhan, Jay Shah, Eric Greif, Evan G Stein
Craniocervical artery dissection is a potentially disabling condition caused by an intimal tear allowing blood to enter and dissect the media in the cranial direction which can occur spontaneously or as a result of trauma. When the dissection extends toward the adventitia, it can form a protrusion from the weakened vessel wall called a pseudoaneurysm, which may become a nidus for distal thromboembolism or cause mass effect on adjacent structures. Accurate and prompt diagnosis is critical as timely treatment can significantly reduce the risk of complications such as stroke...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28485656/delayed-massive-epistaxis-from-traumatic-cavernous-carotid-false-aneurysms-a-report-of-two-unusual-cases
#18
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...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28484831/a-case-of-refractory-subgaleal-hematoma-in-adolescence-treated-with-aspiration-and-endovascular-surgery
#19
Daisuke Wajima, Ichiro Nakagawa, Yukiko Kotani, Takeshi Wada, Hiroshi Yokota, Young-Soo Park, Kimihiko Kichikawa, Hiroyuki Nakase
A 14-year-old boy experienced sudden headache in the left parietal region, without any history of head trauma. Approximately 40 ml of hematoma was aspirated using a 22-gauge needle, and scalp swelling immediately disappeared. However, the swelling recurred bilaterally 2 weeks later. Left external carotid angiography revealed a reticular shadow consistent with subgaleal hematoma from a branch of bilateral superficial temporal arteries, without any arteriovenous shunts. The patient was successfully treated using the combination of hematoma aspiration and embolization of the superficial temporal artery...
May 9, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28480112/nontraumatic-posterior-circulation-pseudoaneurysm-of-the-basilar-artery-summit-with-complete-spontaneous-resolution-case-report-and-literature-review
#20
Nefize Turan, Shannon Butler, Theodore C Larson, Alexander Mason
BACKGROUND: Intracranial pseudoaneurysms are rare vascular defects of arterial walls that are classically the result of traumatic injury, iatrogenic causes, or infection. Idiopathic pseudoaneurysms are seen even less frequently and are often related to atherosclerosis. Pseudoaneurysms are most commonly found along the distal wall of the internal carotid artery, however, can occur at any location in the cerebrovascular circulation. Treatment of these arterial defects is often challenging due to their frail nature...
2017: Surgical Neurology International
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