Urgent Intracranial Carotid Artery Decompression after Penetrating Head Injury.
10.3340/jkns.2013.53.3.180
- Author:
Seong Joon KIM
1
;
Ik Seong PARK
Author Information
1. Department of Neurosurgery, College of Medicine, The Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, Korea. ispahk@yahoo.co.kr
- Publication Type:Case Report
- Keywords:
Penetrating craniofacial injury;
Carotid artery;
Cavernous sinus
- MeSH:
Adhesives;
Angiography, Digital Subtraction;
Carotid Arteries;
Cavernous Sinus;
Decompression;
Foreign Bodies;
Head Injuries, Penetrating;
Hemostasis;
Humans;
Skull Base;
Wounds, Penetrating
- From:Journal of Korean Neurosurgical Society
2013;53(3):180-182
- CountryRepublic of Korea
- Language:English
-
Abstract:
We describe a case of intracranial carotid artery occlusion due to penetrating craniofacial injury by high velocity foreign body that was relieved by decompressive surgery. A 46-year-old man presented with a penetrating wound to his face. A piece of an electric angular grinder disc became lodged in the anterior skull base. Computed tomography revealed that the disc had penetrated the unilateral paraclinoid and suprasellar areas without flow of the intracranial carotid artery on the lesion side. The cavernous sinus was also compromised. Removal of the anterior clinoid process reopened the carotid blood flow, and the injection of glue into the cavernous sinus restored complete hemostasis during extraction of the fragment from the face. Digital subtraction angiography revealed complete recanalization of the carotid artery without any evidence of dissection. Accurate diagnosis regarding the extent of the compromised structures and urgent decompressive surgery with adequate hemostasis minimized the severity of penetrating damage in our patient.
