Traumatic Dissection of Carotid Artery in a 34-Year-Old Patient Presenting to Emergency Department; a Case Report
Iranian Journal of Emergency Medicine,
Vol. 4 No. 1 (2017),
21 December 2016
,
Page 43-40
https://doi.org/10.22037/ijem.v4i1.15360
Abstract
Dissection of neck arteries including carotid artery is among the vascular injuries following blunt neck trauma. Manifestations of this injury are usually delayed and present as neurological problems. This injury is accountable for about 2% of cerebral infarctions but causes 20% of brain strokes in patients less than 45 years old. Aiming to discuss and emphasize the importance of this injury, in this article a case of carotid dissection presenting to emergency department (ED) is presented. The patient was a 34 year-old woman that visited ED following left hemiparesis, dysartery and headache that had initiated a few hours back. She had a history of hospital admission 10 days before due to car accident and rollover, and had been discharged with good general health following required examinations. In brain computed tomography (CT) scan, there was evidence of sub-acute ischemic infarction around the middle cerebral artery. Considering the age of the patient, evidence of wide ischemia and history of recent trauma, neck artery dissection was suspected and angiography was performed, which confirmed the diagnosis of carotid artery dissection.How to Cite
References
Redekop GJ. Extracranial carotid and vertebral artery dissection: a review. The Canadian journal of neurological sciences. 2008;35(02):146-52.
Patel RR, Adam R, Maldjian C, Lincoln CM, Yuen A, Arneja A. Cervical carotid artery dissection: current review of diagnosis and treatment. Cardiology in review. 2012;20(3):145-52.
Seth R, Obuchowski A, Zoarski G. Endovascular repair of traumatic cervical internal carotid artery injuries: a safe and effective treatment option. American Journal of Neuroradiology. 2013;34(6):1219-26.
BAYIR A, KIREŞİ DA, Söylemez A, Demirci O. Cerebral infarction caused by traumatic carotid artery dissection. Ulus Travma Acil Cerrahi Derg. 2012;18(4):347-50.
Lee TS, Ducic Y, Gordin E, Stroman D. Management of carotid artery trauma. Craniomaxillofacial Trauma and Reconstruction. 2014;7(03):175-89.
Baumgartner R, Bogousslavsky J. Clinical manifestations of carotid dissection. Handbook on cerebral artery dissection. 20: Karger Publishers; 2005. p. 70-6.
Biffl WL, Cothren CC, Moore EE, Kozar R, Cocanour C, Davis JW, et al. Western Trauma Association critical decisions in trauma: screening for and treatment of blunt cerebrovascular injuries. Journal of Trauma and Acute Care Surgery. 2009;67(6):1150-3.
Guillon Bt, Lévy C, Bousser M-G. Internal carotid artery dissection: an update. Journal of the neurological sciences. 1998;153(2):146-58.
Brott. Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease. Circulation. 2011;124(4):E145-E.
Crönlein M, Sandmann G, Beirer M, Wunderlich S, Biberthaler P, Huber-Wagner S. Traumatic bilateral carotid artery dissection following severe blunt trauma: a case report on the difficulties in diagnosis and therapy of an often overlooked life-threatening injury. European journal of medical research. 2014;20(1):62-.
Mohan IV. Current optimal assessment and management of carotid and vertebral spontaneous and traumatic dissection. Angiology. 2014;65(4):274-83.
Cothren CC, Moore EE, Biffl WL, Ciesla DJ, Ray Jr CE, Johnson JL, et al. Anticoagulation is the gold standard therapy for blunt carotid injuries to reduce stroke rate. Archives of surgery. 2004;139(5):540-6.
Cothren CC, Biffl WL, Moore EE, Kashuk JL, Johnson JL. Treatment for blunt cerebrovascular injuries: equivalence of anticoagulation and antiplatelet agents. Archives of Surgery. 2009;144(7):685-90.
- Abstract Viewed: 1085 times
- PDF (فارسی) Downloaded: 285 times
- HTML (فارسی) Downloaded: 45 times
