Common Carotid Artery Dissection in Multiple Extracranial Injury: A Case Report.
10.13004/kjnt.2018.14.1.28
- Author:
Jin Sang KIL
1
;
Mi Kyung LEE
;
Ki Seong EOM
Author Information
1. Department of Neurosurgery, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea. kseom@wonkwang.ac.kr
- Publication Type:Case Report
- Keywords:
Common carotid artery;
Dissection;
Traumatic carotid dissection
- MeSH:
Angiography;
Brain;
Carotid Artery, Common*;
Contusions;
Deception;
Diagnosis;
Drinking;
Enoxaparin;
Flail Chest;
Hematoma;
Hemopneumothorax;
Humans;
Infarction, Middle Cerebral Artery;
Lung;
Middle Aged;
Paresis;
Rib Fractures;
Rupture;
Surgeons;
Thoracotomy;
Tomography, X-Ray Computed;
Urinary Bladder
- From:Korean Journal of Neurotrauma
2018;14(1):28-31
- CountryRepublic of Korea
- Language:English
-
Abstract:
Traumatic common carotid artery dissection (CCAD) is rare. To our knowledge, only 14 case reports have described traumatic CCAD previously. Here, we report a case of CCAD in a patient with severe trauma. A 50-year-old man was lying on the road after drinking alcohol when a car drove over him. Computed tomography (CT) revealed multiple rib fractures with hemopneumothorax, lung contusion, flail chest, large amount of hematoma with bladder rupture, and fractures on the C6 spinous process, sacral ala, iliac bone, and pubic ramus. Repair of the bladder rupture, exploratory thoracotomy, and open reduction of multiple rib fractures were performed. Right side hemiparesis was observed on hospital day 4. Brain CT showed a large acute left middle cerebral artery infarction. CT angiography showed focal carotid dissection at the left common carotid artery with intimal flap. The CCAD was located at the C6 level. Clexane (enoxaparin sodium) treatment was initiated. An abdominal CT scan revealed a huge retroperitoneal hematoma and increased amount of hematoma in the prevesical and perivesical space, 10 days later. The patient died two days later. Although traumatic CCAD is rare, this case report provides useful information for trauma surgeons regarding the treatment and diagnosis of similar cases.
