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 injuryReportar como inadecuado




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 - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

European Journal of Medical Research

, 20:62

First Online: 22 July 2015Received: 12 June 2015Accepted: 08 July 2015DOI: 10.1186-s40001-015-0153-1

Cite this article as: Crönlein, M., Sandmann, G.H., Beirer, M. et al. Eur J Med Res 2015 20: 62. doi:10.1186-s40001-015-0153-1

Abstract

BackgroundTraumatic carotid artery dissections are very rare, often overlooked and life-threatening injuries. Diagnosis and treatment are difficult especially in multiple injured patients.

Case presentationWe report on a 28-year-old female major trauma patient injury severity score, ISS 50 who was involved in a motor vehicle accident. She was primarily transferred to a level II trauma center. After initial assessment and operative management, an anisocoria was diagnosed on the intensive care unit. Subsequent CT angiography and extracranial duplex sonography revealed a bilateral internal carotid artery dissection. The patient was transferred to our level I trauma center where conservative treatment with high-dose heparin therapy was started at day two after trauma. Outcome after 6 months was very good.

ConclusionBesides presenting the case and outcome of this patient, the article discusses the diagnostic and therapeutic management of this extremely rare and often overlooked dangerous injury. To avoid overlooking carotid artery dissections, CT angiography of the neck region should be generously included into the initial multislice CT whole-body scan, when the injury results from an according trauma. For the best outcome, sites of hemorrhage should be abolished quickly and the anticoagulative therapy should be initiated as soon as possible. Interdisciplinary treatment of trauma surgeons and neurologists is crucial.

KeywordsNeck injuries Traumatic vessel dissection Internal carotid artery dissection Polytrauma AbbreviationsAISAbbreviated Injury Scale

ATLSAdvanced Trauma Life Support

CADcarotid artery dissection

GCSGlasgow Coma Scale

ICAinternal carotid artery

ISSInjury Severity Scale

MCAmiddle cerebral artery

MVAmotor vehicle accident

NIHSSNational Institute of Health Stroke Scale

Download fulltext PDF



Autor: Moritz Crönlein - Gunther H Sandmann - Marc Beirer - Silke Wunderlich - Peter Biberthaler - Stefan Huber-Wagner

Fuente: https://link.springer.com/



DESCARGAR PDF




Documentos relacionados