Advanced Search

Home > Journals > Journal of Neurosurgical Sciences > Past Issues > Journal of Neurosurgical Sciences 2000 June;44(2) > Journal of Neurosurgical Sciences 2000 June;44(2):103-6

ISSUES AND ARTICLES   MOST READ   eTOC

CURRENT ISSUEJOURNAL OF NEUROSURGICAL SCIENCES

A Journal on Neurosurgery


Indexed/Abstracted in: e-psyche, EMBASE, PubMed/MEDLINE, Neuroscience Citation Index, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,651

 

Journal of Neurosurgical Sciences 2000 June;44(2):103-6

 CASE REPORTS

Fatal carotid dissection after blunt head trauma

Tartara F., Regolo P., Servadei F., Versari P. P., Giovanelli M.

Division of Neurosurgery, and Divisional Neurotraumatology, M. Bufalini Hospital, Cesena, Italy, IRCCS S. Raffaele Hospital, University of Milan, Italy

Occurrence of inter­nal carot­id ­artery inju­ries asso­ciat­ed ­with ­skull ­base frac­ture ­has ­been report­ed. A. ­report a ­case of ­fatal intra­cra­ni­al carot­id dis­sec­tion relat­ed to ­petrous frac­ture involv­ing ­the carot­id ­canal. Identification of carot­id ­lesions ­may be dif­fi­cult ­and gen­er­al­ly relat­ed to appear­ance of unex­pect­ed neu­ro­log­i­cal def­i­cit. Skull ­base frac­tures ­may be con­sid­ered an indi­rect ­sign ­for detec­tion of vas­cu­lar inju­ry. Patterns of ­the frac­ture ­are of par­a­mount impor­tance; rou­tine CT ­scan ­may ­fail to ­detect bas­i­lar frac­tures ­and ­high def­i­ni­tion ­fine-­cut CT ­scan ­should be exe­cut­ed to care­ful­ly iden­ti­fy ­and eval­u­ate frac­tures. Temporal ­and sphe­noid ­bone frac­tures ­are com­mon in ­head trau­ma ­and involve­ment of ­the ­course of ­the carot­id ­artery is fre­quent. The involve­ment of ­the intra­cra­ni­al carot­id ­artery ­course rep­re­sents a ­direct ­risk fac­tor ­for ­lesions of ­the ­petrous, lac­er­um ­and cav­ern­ous seg­ments of ­the carot­id ­artery. Early diag­no­sis of ­post-trau­mat­ic vas­cu­lar inju­ry ­may ­lead to prog­no­sis improve­ment ­because of effec­tive­ness of hep­ar­in anti­co­ag­u­lant ther­a­py. Then vas­cu­lar screen­ing is rec­om­mend­able in cas­es ­with com­plex frac­tures of ­the ­skull ­base ­and par­tic­u­lar­ly frac­tur­ing ­along ­the ­course of ­the carot­id ­artery. Magnetic res­o­nance angio­gra­phy ­may be con­sid­ered ­the ­first ­line diag­nos­tic ­tools ­for vas­cu­lar screen­ing. Angiography ­may be ­reserved ­for ­patients ­with a prov­en ­lesion or rap­id neu­ro­log­i­cal dete­ri­ora­tion tak­ing ­into ­account ­the pos­sibil­ity of inter­ven­tion­al treat­ment.

language: English


FULL TEXT  REPRINTS

top of page