Document Detail


Traumatic cervical artery dissection in head injury: the value of follow-up brain imaging.
MedLine Citation:
PMID:  20580486     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Traumatic cervical artery dissection (TCAD) is a relative infrequent complication of traumatic brain injury (TBI). Since TCAD is associated with morbidity in a considerable percentage of patients, it is important to obtain clues for recognising TCAD in this category of patients.
METHODS: Retrospective case-cohort study in severe TBI patients.
RESULTS: Five patients with traumatic cervical artery dissection after severe TBI, leading to ischemic strokes, are described. Secondary deterioration to coma was present in four out of five patients during admission. The diagnosis of TCAD was delayed in most cases because the secondary deterioration was often attributed to multisystem problems related to trauma patients, i.e. shock or hypoxia or medication effects. Local clinical symptoms and signs suggestive of TCAD are difficult to detect in this patient group. In all patients, the CT-scan on admission demonstrated no abnormalities. A follow-up scan at day 2 revealed that in all patients abnormalities in the vascular territories had evolved.
CONCLUSION: With this case-cohort study we underline the importance of considering TCAD in severe TBI patients and emphasise the role for standard follow-up brain imaging. Also possible treatment consequences are discussed.
Authors:
M J H Aries; B M De Jong; M Uyttenboogaart; J G Regtien; J van der Naalt
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Publication Detail:
Type:  Journal Article     Date:  2010-06-26
Journal Detail:
Title:  Clinical neurology and neurosurgery     Volume:  112     ISSN:  1872-6968     ISO Abbreviation:  Clin Neurol Neurosurg     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-08-27     Completed Date:  2010-12-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7502039     Medline TA:  Clin Neurol Neurosurg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  691-4     Citation Subset:  IM    
Copyright Information:
(c) 2010 Elsevier B.V. All rights reserved.
Affiliation:
Department of Neurology and Critical Care, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands. m.j.h.aries@neuro.umcg.nl
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MeSH Terms
Descriptor/Qualifier:
Adult
Brain Injuries / complications*
Carotid Artery, Internal, Dissection / diagnosis,  etiology*
Case-Control Studies
Cohort Studies
Female
Follow-Up Studies
Glasgow Coma Scale
Humans
Male
Middle Aged
Retrospective Studies
Risk Factors
Tomography, X-Ray Computed
Vertebral Artery Dissection / diagnosis,  etiology*

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