Blunt traumatic carotid dissection with delayed symptoms

We describe five patients with blunt traumatic carotid dissection with delayed clinical presentation that varied from 2 weeks to 6 months. Four patients had severe head injury, and one patient had direct blunt trauma to the neck. Cerebrovascular symptoms developed in four patients. The fifth patient...

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Bibliographic Details
Published in:Stroke (1970) 1989-03, Vol.20 (3), p.412-416
Main Authors: POZZATI, E, GIULIANI, G, POPPI, M, FAENZA, A
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aneurysm, Dissecting - diagnostic imaging
Aneurysm, Dissecting - etiology
Biological and medical sciences
Carotid Artery Diseases - diagnostic imaging
Carotid Artery Diseases - etiology
Cerebral Angiography
Child
Child, Preschool
Craniocerebral Trauma - complications
Female
Humans
Injuries of the nervous system and the skull. Diseases due to physical agents
Male
Medical sciences
Neck Injuries
Time Factors
Traumas. Diseases due to physical agents
Wounds, Nonpenetrating - complications
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Summary:We describe five patients with blunt traumatic carotid dissection with delayed clinical presentation that varied from 2 weeks to 6 months. Four patients had severe head injury, and one patient had direct blunt trauma to the neck. Cerebrovascular symptoms developed in four patients. The fifth patient suffered loss of vision as a result of a concurrent giant intracranial dissecting aneurysm. Arteriography demonstrated a "string sign" in two cases and a cervical carotid aneurysm in three; two of the latter also had siphon occlusion, and one of these had a superimposed supraclinoid dissecting aneurysm. One patient was treated by thromboendarterectomy, one by aneurysmorraphy, another by carotid ligation, and the other two patients were treated medically. Mechanisms of injury, forensic problems, and therapeutic options are discussed.
ISSN:0039-2499
1524-4628
DOI:10.1161/01.STR.20.3.412