This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Noniatrogenic Traumatic Lesions

Gerald B. Zelenock, MD; Andris Kazmers, MD; Walter M. Whitehouse, Jr, MD; Linda M. Graham, MD; Errol E. Erlandson, MD; Jack L. Cronenwett, MD; S. Martin Lindenauer, MD; James C. Stanley, MD

Arch Surg. 1982;117(4):425-432.

Abstract
• Noniatrogenic traumatic extracranial internal carotid artery dissections were encountered in six patients (five men and one woman) 31 to 62 years old. All but one had overt cerebral ischemia manifest by paresis (three), sensory deficits (three), aphasia (three), or amaurosis fugax (two). One patient had an asymptomatic carotid artery bruit. Cerebral arteriography established the diagnosis in all cases. Internal carotid artery impingement between the mandible and transverse processes of the second and third cervical vertebrae, or undue stretching over these vertebral structures, were the most likely primary mechanisms of injury. Secondary complications, a result of distal thromboembolism, were evident in two patients. Direct cerebral revascularization, staged internal carotid artery constriction and ligation, as well as intensive nonoperative therapy were valid therapeutic options. There were no deaths. Treatment relieved transient ischemic symptoms or arrested progression of established neurologic deficits in each case. In select patients, early surgical intervention may lessen attending neurologic sequelae.

(Arch Surg 1982;117:425-432)

Author Affiliations
From the Department of Surgery, University of Michigan Medical School; and Peripheral Vascular Surgery Service, Veterans Administration and University Hospitals, Ann Arbor, Mich.

Footnotes
Accepted for publication Nov 24, 1981.

Read at the Fifth Annual Surgical Symposium of the Association of Veterans Administration Surgeons, Minneapolis, May 14, 1981.

Reprint requests to Department of Surgery, University Hospital, 1405 E Ann St, Ann Arbor, MI 48109 (Dr Zelenock).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Delayed presentation of carotid artery dissection following major orthopaedic trauma resulting in dense hemiparesis
Edmundson et al.
J Bone Joint Surg Br 2009;91-B:536-539.
ABSTRACT | FULL TEXT  

Treatment of cervical artery dissection: a systematic review and meta-analysis
Menon et al.
J. Neurol. Neurosurg. Psychiatry 2008;79:1122-1127.
ABSTRACT | FULL TEXT  

Antiplatelets Versus Anticoagulation in Cervical Artery Dissection
Engelter et al.
Stroke 2007;38:2605-2611.
ABSTRACT | FULL TEXT  

Duplex Ultrasound Recognition of Spontaneous Carotid Dissection: A Case Report and Review of the Literature
Adkins et al.
VASC ENDOVASCULAR SURG 2004;38:455-460.
ABSTRACT  

Acute Post Traumatic Fusiform Aneurysm of the Proximal Left Internal Carotid Artery: A Case Report
Posevitz et al.
VASC ENDOVASCULAR SURG 1985;19:238-242.
ABSTRACT