CASE REPORTS  VASCULAR PAPERS 

The Journal of Cardiovascular Surgery 1998 August;39(4):417-24

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Bilateral thrombosis of the internal carotid arteries after a closed trauma. Advantages of magnetic resonance imaging and review of the literature

Gouny P., Nowak C., Smarrito S., Fadel E., Hocquet-cheynel C., Nussaume O.

From the Vascular and Thoracic Surgery Department, Assistance Publique, Tenon Hospital, Paris, France

Bilateral trau­mat­ic dis­sec­tion of an inter­nal carot­id ­artery (­BTDIC) ­after a ­closed inju­ry is ­very ­rare. We ­report a ­case of bilat­er­al throm­bo­sis ­caused by inter­nal carot­id ­artery dis­sec­tion due to a ­closed inju­ry. The 22 cas­es doc­u­ment­ed in the lit­er­a­ture are ­also ­reviewed. Six of the ­patients (26%) ­were asymp­to­mat­ic at the ­initial exam­ina­tion, but all devel­oped sec­on­dary symp­toms, dur­ing the ­first 48 ­hours. Sixteen ­patients (69%) had asso­ciat­ed trau­mat­ic ­lesions. Six ­patients ­died dur­ing the ­week ­after the acci­dent, all of them had ­initial neu­ro­log­i­cal symp­toms. Magnetic res­o­nance imag­ing (MRI) pro­vid­ed ­more ­items of infor­ma­tion ­than angio­gra­phy, show­ing a dis­sec­tion on an occlud­ed ­artery and a clear­er pic­ture of the ­length of the dis­sec­tion, direct­ly vis­u­al­iz­ing the ­wall hemat­o­ma and a resid­u­al sig­nal ­that ­showed the per­sis­tence or ­arrest of ­blood ­flow. Treatment of ­BTDIC is ­based on ear­ly anti­co­ag­u­la­tion ther­a­py.