Vascular lesions can be serious complications resulting of blunt or penetrating trauma 1,2 . Internal carotid artery lesion is one of most serious and relatively frequent in all mechanisms of craniofacial trauma. Several clinical manifestations can occur as central neurologic and cranial nerves deficits as well as several degrees of bleeding (from mild symptomatic to fatal). Recurrent and massive epistaxis can occur after trauma due to pseudaoneurysms of the external and internal carotid artery (ICA) 3,4 . Considering its life-threatening course, the assisting physician has a relatively narrow time to detect and treat these lesions.We present two cases of recurrent and massive epistaxis secondary to ICA pseudoaneurysm following blunt and perforating trauma. Evolution was fatal in the first case with delayed treatment and uneventfully in the second which was treated by occlusion of the pseudoaneurysm and ICA via endovascular intervention. CASES Case 1A 22-year-old girl suffered a motor vehicle accident with facial and cranial blunt trauma six months earlier. On admission at another institution, she presented nasal and oral bleeding and normal neurological examination (Glasgow score 15). Admission computed tomography (CT) showed basal orbitofrontal and maxillary fracture and no abnormality in the paranasal sinus (Fig 1). In subsequent days, she developed progressive right eye amaurosis, facial hypoesthesia, and epistaxis. Orbital decompressive surgery was performed. Over the next months she had some recurrent nasal bleeding episodes which were controlled by nasal packing. CT performed 5 months later showed an eroding mass in the sphenoidal sinus with enhanced contrast media inside (Fig 2). Magnetic resonance imaging (MRI) showed a flow void inside the mass, and a pseudoaneurysm was suspected

BackgroundTo analyze the face vascularization pattern using B-mode and Doppler ultrasonography, and also propose an arterial vessel mapping.Material and MethodsThe investigation was performed on 20 ultrasonography exams of facial vessels through linear and endocavitary transducers. We analyzed and determined the average values for diameters, peak systolic velocity and resistive index of the following arteries: external carotid, lingual, deep lingual, sublingual, facial, submental, inferior labial, superior labial, angular, maxillary inferior alveolar, mental, buccal, greater palatine, infraorbital, superficial temporal, transverse facial and frontal.ResultsData was obtained allowing the analysis of the tissue hemodynamics. We were able to map the vascularization of the face and it was possible to access three arteries of small diameter (0,60mm angular artery; 0,55mm greater palatine artery; 0,45mm infraorbital artery).ConclusionsThe results presented in this article are valid tool supporting the non-invasive mapping of facial vascularization. Key words:Anatomy, vascularization, ultrasonography, doppler.

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-Thirty-four consecutive adult patients with subdural traumatic hygroma were analysed for clinical evolution, serial computed tomography scan (CT), and magnetic resonance imaging (MRI) over a period of several months. Five of the patients presented CT scan and MRI evolution data showing increasing density over a period of 11 days to 6 months post trauma. In these five patients, final clinical and CT scan data were benign, with complete spontaneous resolution. Descriptions in literature of evolving traumatic subdural hygroma have presented CT scan density modifications changing into chronic subdural hematoma. Our patients show another possibility, density transformation, which sometimes show as subdural hematoma in CT scan and MRI, but with final evolution where clinical condition and CT scan return to normal.KEY WORDS: traumatic subdural hygroma, evolution, head injury, CT scan .Higroma subdural traumático: a propósito de cinco casos com modificação de densidade e resolução espontânea RESUMO -Analisamos 34 pacientes adultos com higroma subdural traumático quanto à evolução clínica, tomografias seriadas e ressonância magnética. Observou-se aumento da densidade do higroma subdural em cinco dos pacientes durante período que variou de 11 dias a 6 meses após o trauma. Nestes cinco pacientes, a evolução clínica foi favorável e os higromas apresentaram resolução espontânea. Há vários relatos na literatura de modificação da densidade dos higromas subdurais tramáticos, transformando-se em hematoma subdural crônico. Esta casuística apresenta outra possibilidade, ou seja, modificação da densidade, que pode ser apresentada como hematoma subdural pelas imagens de tomografia ou ressonância magnética, mas com resultado final das condições clínicas e de imagem retornando ao normal. PALAVRAS-CHAVE: higroma subdural traumático, traumatismo crânio-encefálico, evolução, tomografia computadorizada.Post-traumatic subdural hygroma is common, but its natural history is not well defined because there are few reports of clinical and computed tomography scan (CT) evolution data. These reports lack a uniform approach to method and segment time [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] . Some authors have reported traumatic subdural hygroma presenting density modifications in the CT scan with change to chronic subdural hematoma 4,7,9,10,12,13,[15][16][17][18] . This study reports a series of South American adult patients with traumatic subdural hygroma, with emphasis on the evolution of clinical and CT scan data. METHODThirty-four 34 consecutive adult patients with subdural traumatic hygroma were analyzed; they were analyzed with emphasis on patients who presented density modifications over a follow-up time segment. Each patient was studied for clinical evolution, serial CT scan and magnetic resonance imaging (MRI) data for several months.This study was approved by our University Hospital Ethics Committee for Human Research. RESULTSThere were 34 patients, with ages ranging from 16 to 85 years (mean 40), se...