Carotid Artery Trauma: Management Based on Mechanism of Injury
Fifty-six patients with carotid injuries were reviewed (35 penetrating and 21 blunt). Shock correlated with a profound neurologic deficit on admission (p < 0.03) in those with penetrating wounds. Thirty-one per cent had primary repair, 25% had interposition grafting, 17% were ligated, and 17% wer...
Gespeichert in:
| Veröffentlicht in: | The journal of trauma 1990-08, Vol.30 (8), p.953-963 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 963 |
|---|---|
| container_issue | 8 |
| container_start_page | 953 |
| container_title | The journal of trauma |
| container_volume | 30 |
| creator | FABIAN, TIMOTHY C. GEORGE, SALEM M. CROCE, MARTIN A. MANGIANTE, EUGENE C. VOELLER, GUY R. KUDSK, KENNETH A. |
| description | Fifty-six patients with carotid injuries were reviewed (35 penetrating and 21 blunt). Shock correlated with a profound neurologic deficit on admission (p < 0.03) in those with penetrating wounds. Thirty-one per cent 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 per cent had major associated injuries43% intra-abdominal solid viscus, 24% pelvis/long bone fractures, and 24% cervical spine/facial fractures. Dissections were treated with anticoagulation60% 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. |
| doi_str_mv | 10.1097/00005373-199008000-00003 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_79951409</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>79951409</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4513-3d46ea2b159ec7d2701b188decf8b22ca55052558d999e9030b64c640e7311e33</originalsourceid><addsrcrecordid>eNp1kUtPwzAMgCMEGmPwE5BygVshj6ZNOCCNiZe0ics4R2nqso4-RtJq2r-nZWWcyMWK_dmWPiOEKbmhRMW3pHuCxzygShEiu1_Qp_gRGlPBVCAlUcdoTAhjgWCSnaIz79cdEYZcjtCIcSk5icbofmZc3eQpnroG3A4vnWlLc4cXpjIfUELV4AfjIcV1hRdgV6bKfYnrDL9W69btztFJZgoPF0OcoPenx-XsJZi_Pb_OpvPAhoLygKdhBIYlVCiwccpiQhMqZQo2kwlj1ghBBBNCpkopUISTJAptFBKIOaXA-QRd7-duXP3Vgm90mXsLRWEqqFuvY6UEDYnqQLkHrau9d5DpjctL43aaEt2r07_q9EHdT6rfcTnsaJMS0kPj4KqrXw11460pMmcqm_u_-YrFnPOeC_fcti46p_6zaLfg9ApM0az0f5fj37SRg2s</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>79951409</pqid></control><display><type>article</type><title>Carotid Artery Trauma: Management Based on Mechanism of Injury</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>FABIAN, TIMOTHY C. ; GEORGE, SALEM M. ; CROCE, MARTIN A. ; MANGIANTE, EUGENE C. ; VOELLER, GUY R. ; KUDSK, KENNETH A.</creator><creatorcontrib>FABIAN, TIMOTHY C. ; GEORGE, SALEM M. ; CROCE, MARTIN A. ; MANGIANTE, EUGENE C. ; VOELLER, GUY R. ; KUDSK, KENNETH A.</creatorcontrib><description>Fifty-six patients with carotid injuries were reviewed (35 penetrating and 21 blunt). Shock correlated with a profound neurologic deficit on admission (p < 0.03) in those with penetrating wounds. Thirty-one per cent 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 per cent had major associated injuries43% intra-abdominal solid viscus, 24% pelvis/long bone fractures, and 24% cervical spine/facial fractures. Dissections were treated with anticoagulation60% 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.</description><identifier>ISSN: 0022-5282</identifier><identifier>EISSN: 1529-8809</identifier><identifier>DOI: 10.1097/00005373-199008000-00003</identifier><identifier>PMID: 2388306</identifier><identifier>CODEN: JOTRA5</identifier><language>eng</language><publisher>Baltimore, MD: Williams & Wilkins</publisher><subject>Adolescent ; Adult ; Aged ; Anticoagulants - adverse effects ; Anticoagulants - therapeutic use ; Biological and medical sciences ; Carotid Arteries - diagnostic imaging ; Carotid Artery Injuries ; Cerebrovascular Disorders - etiology ; Female ; Hemiplegia - etiology ; Humans ; Male ; Medical sciences ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed ; Traumas. Diseases due to physical agents ; Vascular injuries: limbs, aorta, vena cava ; Wounds, Nonpenetrating - complications ; Wounds, Nonpenetrating - diagnostic imaging ; Wounds, Nonpenetrating - surgery ; Wounds, Nonpenetrating - therapy ; Wounds, Penetrating - complications ; Wounds, Penetrating - surgery ; Wounds, Penetrating - therapy</subject><ispartof>The journal of trauma, 1990-08, Vol.30 (8), p.953-963</ispartof><rights>Williams & Wilkins 1990. All Rights Reserved.</rights><rights>1991 INIST-CNRS</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4513-3d46ea2b159ec7d2701b188decf8b22ca55052558d999e9030b64c640e7311e33</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19273336$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/2388306$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>FABIAN, TIMOTHY C.</creatorcontrib><creatorcontrib>GEORGE, SALEM M.</creatorcontrib><creatorcontrib>CROCE, MARTIN A.</creatorcontrib><creatorcontrib>MANGIANTE, EUGENE C.</creatorcontrib><creatorcontrib>VOELLER, GUY R.</creatorcontrib><creatorcontrib>KUDSK, KENNETH A.</creatorcontrib><title>Carotid Artery Trauma: Management Based on Mechanism of Injury</title><title>The journal of trauma</title><addtitle>J Trauma</addtitle><description>Fifty-six patients with carotid injuries were reviewed (35 penetrating and 21 blunt). Shock correlated with a profound neurologic deficit on admission (p < 0.03) in those with penetrating wounds. Thirty-one per cent 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 per cent had major associated injuries43% intra-abdominal solid viscus, 24% pelvis/long bone fractures, and 24% cervical spine/facial fractures. Dissections were treated with anticoagulation60% 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.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Anticoagulants - adverse effects</subject><subject>Anticoagulants - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Carotid Arteries - diagnostic imaging</subject><subject>Carotid Artery Injuries</subject><subject>Cerebrovascular Disorders - etiology</subject><subject>Female</subject><subject>Hemiplegia - etiology</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Tomography, X-Ray Computed</subject><subject>Traumas. Diseases due to physical agents</subject><subject>Vascular injuries: limbs, aorta, vena cava</subject><subject>Wounds, Nonpenetrating - complications</subject><subject>Wounds, Nonpenetrating - diagnostic imaging</subject><subject>Wounds, Nonpenetrating - surgery</subject><subject>Wounds, Nonpenetrating - therapy</subject><subject>Wounds, Penetrating - complications</subject><subject>Wounds, Penetrating - surgery</subject><subject>Wounds, Penetrating - therapy</subject><issn>0022-5282</issn><issn>1529-8809</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1990</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUtPwzAMgCMEGmPwE5BygVshj6ZNOCCNiZe0ics4R2nqso4-RtJq2r-nZWWcyMWK_dmWPiOEKbmhRMW3pHuCxzygShEiu1_Qp_gRGlPBVCAlUcdoTAhjgWCSnaIz79cdEYZcjtCIcSk5icbofmZc3eQpnroG3A4vnWlLc4cXpjIfUELV4AfjIcV1hRdgV6bKfYnrDL9W69btztFJZgoPF0OcoPenx-XsJZi_Pb_OpvPAhoLygKdhBIYlVCiwccpiQhMqZQo2kwlj1ghBBBNCpkopUISTJAptFBKIOaXA-QRd7-duXP3Vgm90mXsLRWEqqFuvY6UEDYnqQLkHrau9d5DpjctL43aaEt2r07_q9EHdT6rfcTnsaJMS0kPj4KqrXw11460pMmcqm_u_-YrFnPOeC_fcti46p_6zaLfg9ApM0az0f5fj37SRg2s</recordid><startdate>199008</startdate><enddate>199008</enddate><creator>FABIAN, TIMOTHY C.</creator><creator>GEORGE, SALEM M.</creator><creator>CROCE, MARTIN A.</creator><creator>MANGIANTE, EUGENE C.</creator><creator>VOELLER, GUY R.</creator><creator>KUDSK, KENNETH A.</creator><general>Williams & Wilkins</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199008</creationdate><title>Carotid Artery Trauma: Management Based on Mechanism of Injury</title><author>FABIAN, TIMOTHY C. ; GEORGE, SALEM M. ; CROCE, MARTIN A. ; MANGIANTE, EUGENE C. ; VOELLER, GUY R. ; KUDSK, KENNETH A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4513-3d46ea2b159ec7d2701b188decf8b22ca55052558d999e9030b64c640e7311e33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1990</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Anticoagulants - adverse effects</topic><topic>Anticoagulants - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Carotid Arteries - diagnostic imaging</topic><topic>Carotid Artery Injuries</topic><topic>Cerebrovascular Disorders - etiology</topic><topic>Female</topic><topic>Hemiplegia - etiology</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Tomography, X-Ray Computed</topic><topic>Traumas. Diseases due to physical agents</topic><topic>Vascular injuries: limbs, aorta, vena cava</topic><topic>Wounds, Nonpenetrating - complications</topic><topic>Wounds, Nonpenetrating - diagnostic imaging</topic><topic>Wounds, Nonpenetrating - surgery</topic><topic>Wounds, Nonpenetrating - therapy</topic><topic>Wounds, Penetrating - complications</topic><topic>Wounds, Penetrating - surgery</topic><topic>Wounds, Penetrating - therapy</topic><toplevel>online_resources</toplevel><creatorcontrib>FABIAN, TIMOTHY C.</creatorcontrib><creatorcontrib>GEORGE, SALEM M.</creatorcontrib><creatorcontrib>CROCE, MARTIN A.</creatorcontrib><creatorcontrib>MANGIANTE, EUGENE C.</creatorcontrib><creatorcontrib>VOELLER, GUY R.</creatorcontrib><creatorcontrib>KUDSK, KENNETH A.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of trauma</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>FABIAN, TIMOTHY C.</au><au>GEORGE, SALEM M.</au><au>CROCE, MARTIN A.</au><au>MANGIANTE, EUGENE C.</au><au>VOELLER, GUY R.</au><au>KUDSK, KENNETH A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Carotid Artery Trauma: Management Based on Mechanism of Injury</atitle><jtitle>The journal of trauma</jtitle><addtitle>J Trauma</addtitle><date>1990-08</date><risdate>1990</risdate><volume>30</volume><issue>8</issue><spage>953</spage><epage>963</epage><pages>953-963</pages><issn>0022-5282</issn><eissn>1529-8809</eissn><coden>JOTRA5</coden><abstract>Fifty-six patients with carotid injuries were reviewed (35 penetrating and 21 blunt). Shock correlated with a profound neurologic deficit on admission (p < 0.03) in those with penetrating wounds. Thirty-one per cent 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 per cent had major associated injuries43% intra-abdominal solid viscus, 24% pelvis/long bone fractures, and 24% cervical spine/facial fractures. Dissections were treated with anticoagulation60% 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.</abstract><cop>Baltimore, MD</cop><pub>Williams & Wilkins</pub><pmid>2388306</pmid><doi>10.1097/00005373-199008000-00003</doi><tpages>11</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0022-5282 |
| ispartof | The journal of trauma, 1990-08, Vol.30 (8), p.953-963 |
| issn | 0022-5282 1529-8809 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_79951409 |
| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adolescent Adult Aged Anticoagulants - adverse effects Anticoagulants - therapeutic use Biological and medical sciences Carotid Arteries - diagnostic imaging Carotid Artery Injuries Cerebrovascular Disorders - etiology Female Hemiplegia - etiology Humans Male Medical sciences Middle Aged Retrospective Studies Tomography, X-Ray Computed Traumas. Diseases due to physical agents Vascular injuries: limbs, aorta, vena cava Wounds, Nonpenetrating - complications Wounds, Nonpenetrating - diagnostic imaging Wounds, Nonpenetrating - surgery Wounds, Nonpenetrating - therapy Wounds, Penetrating - complications Wounds, Penetrating - surgery Wounds, Penetrating - therapy |
| title | Carotid Artery Trauma: Management Based on Mechanism of Injury |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-01T16%3A49%3A04IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Carotid%20Artery%20Trauma:%20Management%20Based%20on%20Mechanism%20of%20Injury&rft.jtitle=The%20journal%20of%20trauma&rft.au=FABIAN,%20TIMOTHY%20C.&rft.date=1990-08&rft.volume=30&rft.issue=8&rft.spage=953&rft.epage=963&rft.pages=953-963&rft.issn=0022-5282&rft.eissn=1529-8809&rft.coden=JOTRA5&rft_id=info:doi/10.1097/00005373-199008000-00003&rft_dat=%3Cproquest_cross%3E79951409%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=79951409&rft_id=info:pmid/2388306&rfr_iscdi=true |