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Carotid trauma

Naureen Narula, Faraz Siddiqui, Nakul Katyal, Akshay Avula, Michel Chalhoub
Internal carotid artery dissection (ICAD) accounts for 25% of cerebrovascular accidents in young and middle-aged patients. Dissection occurs when the intimal wall of an artery is damaged as a result of trauma or defect. ICAD development after dental work is a relatively uncommon phenomenon. Our study highlights a rare presentation of ICAD that resulted from a direct lidocaine nerve block injection in a patient undergoing pulpotomy for a right maxillary second premolar tooth. We have described the case and reviewed the literature on this rare but potentially life-threatening phenomenon...
January 5, 2018: Curēus
Bart Depreitere, Geert Meyfroidt, Fabian Güiza
INTRODUCTION: No consensus exists on the exact method for measuring mean arterial blood pressure (MAP) in the definition of cerebral perfusion pressure (CPP). The aim of the current study is to investigate how different MAP measurement methods have influenced the CPP recommendations in the Brain Trauma Foundation (BTF) guidelines. METHODS: All papers on which the chapter on CPP thresholds in the 2007 version of the BTF guidelines is based, were reviewed. If accurate descriptions of head of bed elevation and arterial pressure transducer height were lacking, the authors were emailed for clarification...
2018: Acta Neurochirurgica. Supplement
Gabriel Neves Saad Teles, Paulo Eduardo Zerati Monteiro, Raphael Raphe
INTRODUCTION: Splenosis is defined as the heterotopic autoimplantation of splenic tissue following trauma to or surgery on the spleen. CLINICAL CASE: We present a case of an asymptomatic 73-year-old male in whom hypervascular lesions were detected during routine exams. The patient reported a history of carotid artery surgery and cholecystectomy; he had a laparotomy incision from childhood but was unaware of the reason for it. The patient exhibited slightly elevated carcinoembryonic antigen (CEA) levels...
February 17, 2018: International Journal of Surgery Case Reports
Alessandro Prior, Luca Allegretti, Ilaria Melloni, Marta Bovio, Francesco Laganà, Marco Ceraudo, Gianluigi Zona
We present a case of ophthalmic artery (OA) traumatic avulsion, leading to a post-traumatic subarachnoid hemorrhage (SAH) with ventricular blood invasion and hydrocephalus, mimicking an internal carotid aneurysm rupture. This is the third case of such an event reported in literature and the first without orbital fractures and optic nerve avulsion. Conservative treatment was sufficient for the avulsion, but surgery was needed for the coexisting eye luxation. Traumatic OA avulsion is a rare but possible event and should be suspected in case of basal cisterns SAH, evidence of orbital trauma and CT angiogram or angiographic absence of opacification of the OA...
February 14, 2018: Acta Neurochirurgica
Benjamin Z Ball, Panayiotis E Pelargos, Catherine Christie, Kiarash Golshani
Background: Direct, Type A, cavernous-carotid fistulas (CCFs) are predominantly caused by head trauma, especially when basilar skull fractures are present. Transarterial endovascular treatment of direct CCFs is the preferred method of treatment. Bilateral CCFs are estimated to be present in 1-2% of the cases. The treatment of bilateral CCFs is difficult often requiring a combination of endovascular and open surgical approaches. Case Description: We present a case of traumatic bilateral CCFs presenting with vasospasm of the anterior circulation seen on the initial angiogram on day 1 and our treatment paradigm...
2018: Surgical Neurology International
Andreas Schicho, Lukas Luerken, Ramona Meier, Antonio Ernstberger, Christian Stroszczynski, Andreas Schreyer, Lena-Marie Dendl, Stephan Schleder
Purpose: The aim of this study was to evaluate the true incidence of cervical artery dissections (CeADs) in trauma patients with an Injury Severity Score (ISS) of ≥16, since head-and-neck computed tomography angiogram (CTA) is not a compulsory component of whole-body trauma computed tomography (CT) protocols. Patients and methods: A total of 230 consecutive trauma patients with an ISS of ≥16 admitted to our Level I trauma center during a 24-month period were prospectively included...
2018: Therapeutics and Clinical Risk Management
Ryota Sasaki, Yasushi Motoyama, Ichiro Nakagawa, Young-Su Park, Hiroyuki Nakase
To present a unique case of the internal carotid artery-posterior communicating artery (ICA-PcomA) aneurysm penetrating the oculomotor nerve presenting a pure acute subdural hematoma (ASDH) without any oculomotor dysfunction. A 71-year-old woman presented with a sudden headache and drowsiness. She had no history of head trauma and did not manifest any neurological deficits including oculomotor nerve palsy. Computed tomography (CT) of her head revealed left ASDH. Subsequent CT angiography showed an aneurysm originating from the left ICA with an inferior projection having continuity with the hematoma...
January 29, 2018: Neurologia Medico-chirurgica
Alistair Jukes, Rodney Allan
Carotid endarterectomy is a commonly performed operation to remove plaque at the region of the carotid bifurcation. We present our technique to keep the field clear and to minimize potential trauma to the carotid using a neurosurgical external ventricular drain passed behind the common carotid and placed in the dependent position under the arteriotomy.
March 2017: Journal of Vascular Surgery Cases and Innovative Techniques
Jessica E Martin, Victoria Sandilands, Julian Sparrey, Laurence Baker, Dorothy E F McKeegan
Urgent development of alternative on-farm killing methods for poultry is required following the number restrictions placed on the use of traditional manual cervical dislocation by European Legislation (EU 1099/2009). Alternatives must be proven to be humane and, crucially, practical in commercial settings with multiple users. We assessed the performance and reliability of a novel mechanical cervical dislocation device (NMCD) compared to the traditional manual cervical dislocation (MCD) method. NMCD was based on a novel device consisting of a thin supportive glove and two moveable metal finger inserts designed to aid the twisting motion of cervical dislocation...
January 10, 2018: Animals: An Open Access Journal From MDPI
Cameron Ludt, Michelle Leppert, Asher Jones, John Song, David Kuwayama, Daniel M Pastula, Sharon Poisson
Hyoid bone elongation is an uncommon cause of stroke. Here, we report a case of hyoid bone elongation causing localized trauma to the internal carotid artery, resulting in multiple strokes. A 32-year-old woman presented with unilateral weakness and history of a recent stroke. Imaging revealed the greater horn of the hyoid bone extending between the external and internal carotid with associated thrombus at the carotid bifurcation and acute stroke. Carotid ultrasound demonstrated movement of the hyoid bone in and out of the space between the external carotid artery and internal carotid artery with neck rotation...
January 2018: Neurohospitalist
Ting Wang, Changwei Zhang, Xiaodong Xie
A teenager with epistaxis after head trauma was diagnosed with pseudoaneurysm of internal carotid artery. Three years after the first aneurysm embolization, delayed coil migration was detected. Then the migrated coil was removed through nasal-endoscopy.
December 16, 2017: World Neurosurgery
Shih-Hsuan Mao, Tzu-Chin Lin, Chih-Hao Chen, Pang-Yun Chou, Shang-Yu Wang, Yon-Cheong Wong, Chien-Tzung Chen
BACKGROUND: Traumatic carotid-cavernous sinus fistula (tCCF) is infrequent but with high morbidity if delayed diagnosed or managed. Due to the lack of screening criteria and requirement of advanced and invasive radiological examinations, diagnosis is often delayed or underdiagnosed. METHODS: A matched case-control study with univariate and multivariate analysis was conducted to predict tCCFs. Forty-six patients diagnosed with tCCFs were included and matched with 138 patients of craniofacial trauma without tCCF as control at a ratio of 1:3...
December 14, 2017: Journal of Trauma and Acute Care Surgery
Matthew R Reynolds, Eric J Arias, Colin P Derdeyn, Albert H Kim
No abstract text is available yet for this article.
February 2018: Journal of Neurosurgical Sciences
Lorna Leandro, Giovanni Dolci, Satheesh Prabhu, Rufus Corkill
A traumatic caroticocavernous fistula (CCF) is an acquired, abnormal communication between the internal carotid artery and the cavernous sinus, secondary to trauma. This rare condition can initially be misdiagnosed, because its presentation shares features common to those of facial trauma, which can result in serious complications. We describe a case of bilateral CCF in an adult patient after a road traffic accident.
November 23, 2017: Journal of Oral and Maxillofacial Surgery
Hiroyuki Otsuka, Toshiki Sato, Keiji Sakurai, Hiromichi Aoki, Takeshi Yamagiwa, Shinichi Iizuka, Sadaki Inokuchi
INTRODUCTION: Recently, trauma management has been markedly improved with interventional radiology (IVR) and damage-control strategies. However, the indications for its use in hemodynamically unstable patients with severe trauma remains unclear. In some cases, IVR may be more effective than surgery for damage-control hemostasis; however, performing IVR in life-threatening trauma settings is challenging. To address this, we practiced and evaluated a trauma-management system with emergency physicians who trained for both severe trauma management, and techniques of surgery and IVR...
February 2018: Injury
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
Chih-Fan Yeh, Yin-Hsien Chen, Mao-Shin Lin, Ching-Chang Huang, Chi-Sheng Hung, Shih-Wei Meng, Chih-Kuo Lee, Hsien-Li Kao
BACKGROUND AND PURPOSE: In addition to head trauma and cranial surgery, endovascular intervention for chronic carotid artery occlusion (CAO) may also result in carotid-cavernous fistula (CCF). The management and prognosis of iatrogenic CCF during CAO recanalization have never been well described and discussed in the literature. MATERIALS AND METHODS: We conducted a retrospective analysis for CAO recanalization attempts in National Taiwan University Hospital and affiliated hospitals...
December 4, 2017: Catheterization and Cardiovascular Interventions
A Dammak, H Ben Jmaà, S Hadhri, H Cheikhrouhou, F Dhouib, S Haddar, L Kammoun, T Ben Jmaà, B Hammami, S Masmoudi, N Elleuch, M Ben Jmaà, I Frikha
The neck, being not protected by skeleton, is vulnerable to external trauma and injury which can involve blood vessels, muscles, nerves, and trachea. Carotid injuries can be potentially life-threatening by hemorrhage and stroke. We present a case of a 26-year-old manual worker who presented a neck injury caused by a metallic projectile. The injury involved the right common carotid artery with an internal jugular vein fistula, and tracheal damage. The patient was managed with surgical repair of the tracheal lesion, reconstruction of the carotid section using a PTFE graft bypass, and ligation of the internal jugular vein...
December 2017: Journal de Médecine Vasculaire
F Raherinantenaina, R A L Rakotorahalahy, M C G Andrianandraina, H N Rakoto Ratsimba, T M A Rajaonanahary
A false aneurysm or pseudoaneurysm (PA) is the formation of a pulsatile and encapsulated hematoma in communication with the lumen of a perforated artery. Its origin is different but most cases are associated with a traumatic event. Currently, the referenced treatment is endovascular surgery but it is not feasible for the majority of vascular surgeons working in a tropical environment. The aim of this study was to describe the diagnostic and therapeutic aspects of arterial PA (APA) encountered in our institution and to evaluate the place of open surgical technique in their management...
December 2017: Journal de Médecine Vasculaire
Bunyada Putthirangsiwong, Dinesh Selva, Weerawan Chokthaweesak, Ekachat Chanthanaphak, Sirintara Singhara Na Ayudhaya
The authors describe the case of an 11-year-old boy with no history of prior trauma, who experienced acute proptosis and visual loss while showering. Diagnostic carotid artery angiography revealed an orbital lymphatic-venous malformation (LVM) concomitant with an intraorbital arteriovenous fistula. The patient was treated with transvenous coil and N-butyl cyanoacrylate glue embolization, combined with direct percutaneous glue injection into the LVM followed by excision. There was good clinical and radiological response without recurrence at the 2-year follow-up...
February 2018: Journal of Neurosurgery. Pediatrics
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