Document Detail

Carotid artery trauma: management based on mechanism of injury.
MedLine Citation:
PMID:  2388306     Owner:  NLM     Status:  MEDLINE    
Fifty-six patients with carotid injuries were reviewed (35 penetrating and 21 blunt). Shock correlated with a profound neurologic deficit on admission (p less than 0.03) in those with penetrating wounds. Thirty-one percent had primary repair, 25% had interposition grafting, 17% were ligated, and 17% were anticoagulated. Two graft failures resulted in death. Three blunt common carotid injuries followed direct cervical soft-tissue trauma; 18 internal carotid (ICA) dissections followed apparent extreme neck extension or flexion. Seven had bilateral ICA dissections (39%); none of these died. All dissections were diagnosed by angiography prompted by a change in the neurologic examination or an initial neurologic deficit unexplained by CT scan. Seventy-one percent had major associated injuries; 43% intra-abdominal solid viscus, 24% pelvis/long bone fractures, and 24% cervical spine/facial fractures. Dissections were treated with anticoagulation; 60% improved, 23% were unchanged, and 17% deteriorated. It is concluded that interposition grafting should be avoided if possible following penetrating wounds; liberal angiography is warranted with incompatible CT findings following blunt trauma; and anticoagulation is safe and effective therapy for blunt carotid dissections.
T C Fabian; S M George; M A Croce; E C Mangiante; G R Voeller; K A Kudsk
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of trauma     Volume:  30     ISSN:  0022-5282     ISO Abbreviation:  J Trauma     Publication Date:  1990 Aug 
Date Detail:
Created Date:  1990-09-24     Completed Date:  1990-09-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  953-61; discussion 961-3     Citation Subset:  AIM; IM    
Department of Surgery, Presley Regional Trauma Center, Memphis, Tennessee 38163.
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MeSH Terms
Anticoagulants / adverse effects,  therapeutic use
Carotid Arteries / radiography
Carotid Artery Injuries*
Cerebrovascular Disorders / etiology
Hemiplegia / etiology
Middle Aged
Retrospective Studies
Tomography, X-Ray Computed
Wounds, Nonpenetrating / complications,  radiography,  surgery,  therapy*
Wounds, Penetrating / complications,  surgery,  therapy*
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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