Delayed bilateral internal carotid artery dissection following motor vehicle accident: time to make its screening a part of trauma protocol?

Agarwal, Amit; Yadav, Dhananjay; Gupta, Anish; Vishnu, Venugopalan Y; Rajan, Roopa; Singh, Meharban; Bhatia, Ravi; Mv, Padma

doi:10.1093/qjmed/hcaa037

Cited by 2 publications

(3 citation statements)

References 6 publications

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“…Approximately 10% to 50% of TICADs present with abrupt symptoms within the first 24 hours after trauma [1,5]. However, symptoms may be delayed.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, CTA is recommended as the initial screening modality [5]. In traumatic patients with symptoms or signs of injuries around the neck, screening CTA is important for early diagnosis and treatment of arterial dissection [1]. However, CTA sometimes fails to detect cerebrovascular injuries [6].…”

Section: Discussionmentioning

confidence: 99%

“…Traumatic internal carotid artery dissection (ICAD) is rare [1]. It usually occurs at the level of the 1st and 2nd cervical vertebraes, which are the most movable segments of the carotid arteries [2].…”

Section: Introductionmentioning

confidence: 99%

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Traumatic intracranial internal carotid artery dissection and pseudoaneurysm presenting as oculomotor nerve palsy

Kim

Seo

2021

Precis Future Med

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The diagnosis of internal carotid artery dissection after trauma is often delayed or missed due to other injuries, leading to potentially permanent neurologic deficits, or even death. Early diagnosis and treatment can prevent devastating consequences. In this report, we present a case of delayed onset but rapidly progressive traumatic intracranial internal carotid artery dissection to emphasize the timing of magnetic resonance imaging with angiography.

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“…Approximately 10% to 50% of TICADs present with abrupt symptoms within the first 24 hours after trauma [1,5]. However, symptoms may be delayed.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Traumatic intracranial internal carotid artery dissection and pseudoaneurysm presenting as oculomotor nerve palsy

Kim

Seo

2021

Precis Future Med

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Bilateral Blunt Traumatic Dissections of the Extracranial Internal Carotid Artery: A Case Report and Literature Review

Khormi,

Darraj,

Arishy

et al. 2024

Cureus

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Bilateral traumatic dissections of the cervical internal carotid artery (ICA) are rare complications of polytrauma. A thorough literature review was performed, and data from selected studies were analyzed to assess the trends in clinical presentation, modes of trauma, management protocols, and clinical outcomes. The reported outcomes were categorized and graded into optimal, intermediate, and poor outcomes. We describe a rare case of bilateral dissection of ICA in a 31-year-old woman who was involved in a motor vehicle accident. She had a Glasgow Coma Scale score of 9 and right-sided hemiparesis. Radiological findings revealed left upper ICA dissection, arterial intramural thrombus, and stenosis of the upper segment of the right ICA. She improved on conservative management and had a good clinical outcome at a three-month follow-up. Emergency physicians must be knowledgeable about such cases, as more than half of these trauma victims are initially asymptomatic on initial presentation. Specific diagnostic and therapeutic modalities should be implemented based on low threshold clinical suspicion to avoid missing these potentially disabling injuries and reduce morbidity and mortality. Computed tomographic angiography is recommended in cases with atypical clinical presentations, unexplained neurological deficits, or delayed-onset clinical deterioration. While antiplatelet and anticoagulant therapies are the mainstays of conservative management, endovascular and surgical management are only used in severe cases when medical treatment has failed, the artery has been completely transected, or there is active bleeding. Generally, good outcomes were reported in about two-thirds of those patients.

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Delayed bilateral internal carotid artery dissection following motor vehicle accident: time to make its screening a part of trauma protocol?

Cited by 2 publications

References 6 publications

Traumatic intracranial internal carotid artery dissection and pseudoaneurysm presenting as oculomotor nerve palsy

Traumatic intracranial internal carotid artery dissection and pseudoaneurysm presenting as oculomotor nerve palsy

Bilateral Blunt Traumatic Dissections of the Extracranial Internal Carotid Artery: A Case Report and Literature Review

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