Traumatic Thrombosis of the Internal Carotid Artery

Hockaday, T. D. R.

doi:10.1136/jnnp.22.3.229

Cited by 45 publications

(7 citation statements)

References 8 publications

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“…The occlusion may occur in the cervical portion of the artery (Verneuil, 1872;Greco, 1935;Cairns, 1942;Northcroft and Morgan, 1945;Caldwell and Hadden, 1948;Schneider and Lemmen, 1952;Clarke, Dickson, and Smith, 1955;Sedzimir, 1955;Murray, 1957;Hockaday, 1959;Humphrey and Newton, 1960;Gurdjian, Hardy, Lindner, and Thomas, 1963;Therkelsen and Hornnes, 1963;Houck, Jackson, Odom, and Young, 1964;Toakley and McCaffrey, 1965;Pitner, 1966;Miller and Ayers, 1967;Hughes and Brownell, 1968;Verbiest and Calliauw, 1969); or at the base of the skull (Hockaday, Thomson, 1963;Mastaglia, Savas, and Kakulas, 1969); or in the intracranial portion of the artery or its branches (de Veer and Browder, 1942;Dratz and Woodhall, 1947;Sedzimir, 1955;Shaw and Foltz, 1968). The occlusion can occur with or without a fracture of the base of the skull; but, when a basal skull fracture occurs, the site of the occlusion tends to be at the base of the skull or in the carotid canal (Sedzimir, 1955;Thomson, 1963;Houck et al 1964).…”

Section: Discussionmentioning

confidence: 99%

Injury of the basilar artery associated with closed head trauma

Shaw

Alvord

1972

Journal of Neurology, Neurosurgery & Psychiatry

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SUMMARYThe neuropathological findings at necropsy are described in three cases of basilar artery injuries and their consequences after head trauma and the mechanism of injuries is discussed. The first case was that of massive pontine infarct due to an occlusion of the basilar artery trapped in the fracture of the clivus, 13 days before death. The second case, also with a pontine infarct, survived for two and two-thirds months; the trauma was probably similar, but the presence of the basal skull fracture and the occlusion of the basilar artery can be surmised only in retrospect. The third case was one of delayed rupture of the basilar artery occurring three to four weeks after the injury, which caused aneurysmal formation in the left posterior cerebral artery.Since blood vessels are components of most organs and tissues, vascular damage of various types is almost inevitable with trauma of any tissues. Epidural, subdural, and intracerebral haemorrhages are well-established clinical and pathological entities related to the laceration of the meningeal artery, superficial cortical veins, and smaller intracerebral vessels, respectively.Traumatic internal carotid artery thrombosis is another entity more recently recognized. Other disorders include dissecting aneurysm, delayed rupture, false and true aneurysmal formation with or without rupture, and embolization; these occur infrequently and the recognition of these conditions is extremely difficult without careful necropsy studies. These vascular complications appear to be particularly rare in the posterior circulation of the brain involving the vertebral and basilar artery system.In the following report, three cases that came to necropsy of basilar artery injuries associated with head trauma are presented. The mechanism of the injury in these cases was quite unusual. Two cases showed massive pontine infarct due to an occlusion of the basilar artery, in one case shown to be trapped in the fracture of the clivus.

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Section: Discussionmentioning

confidence: 99%

Injury of the basilar artery associated with closed head trauma

Shaw

Alvord

1972

Journal of Neurology, Neurosurgery & Psychiatry

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“…Arteriography may also provide some information by locating the site of initimal disruption and thrombus formation and thus its relation to other structures. In some cases, occlusion or stenosis has been seen in the upper neck or at the base of the skull (Boldrey et al 1956, Frantzen et al 1961, Friedenberg et al 1973, Garg et al 1968, Hockaday 1959, Hornet et al 1970, Little et aI. 1969, Mastaglia et al 1971, Miller and Ayers 1967, New and Momose 1969, Ritchie 1961, Schneider 1973, Sullivan et al 1973, Thompson 1963, suggesting that injury occurred at or in the carotid canal or over the upper cervical vertebrae.…”

Section: Pathophysiologymentioning

confidence: 95%

Non-penetrating trauma to the carotid artery with secondary thrombosis and embolism: Treatment by Thrombolysin

1977

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A case of partially occluding post-traumatic thrombosis of the internal carotid artery and secondary embolism of the middle cerebral artery is reported. The patient was treated with Thrombolysin with coincident resolution of clinical symptoms and signs and clearing of the lesions on arteriography. This may have been fortuitous. The subject of traumatic carotid artery thrombosis is reviewed in detail, and its pathophysiology is discussed, especially in relation to facts known about occlusive vascular disease secondary to atherosclerosis and related embolic phenomena. Suggestions are made concerning the treatment of this condition, especially with regard to developing rational criteria for opening vascular beds through evaluation of collateral cerebral blood flow. The uses of microvascular surgical techniques and thrombolytic therapy are considered.

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“…2,6) Obstructions are often located at or just above the bifurcation of the common carotid artery in this type of traumatic ICA occlusion, in contrast to the ICA occlusion due to atherosclerotic change. 4,11) Traumatic ICA occlusion often leads to a poor outcome and the mortality is 37%, regardless of the mechanism of occlusion. 10,11) Insufficient collateral circulation is the major cause of neurological deterioration.…”

Section: ) Radiologicalmentioning

confidence: 99%

“…Neurological deficits appear at more than 6 hours after trauma. 2,4,[6][7][8]11) Delayed onset may be a consequence of progressive occlusion caused by dissection or subintimal hemorrhage. 2,6) Embolism is another cause of neurological deterioration after traumatic ICA occlusion, even in patients with sufficient collateral circulation.…”

Section: ) Radiologicalmentioning

confidence: 99%

Traumatic Cervical Internal Carotid Artery Occlusion in an Infant-Case Report-

Igarashi

Mori²,

Moro³

et al. 2005

Neurol. Med. Chir.(Tokyo)

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A 10-month-old boy presented with traumatic internal carotid artery (ICA) occlusion caused by blunt injury after falling from a baby carrier attached to a standing bicycle. Physical examination found bruises on the scalp in the right temporal region and the right shoulder, but no wound in the neck. Chest radiography showed a right clavicular fracture. He developed left hemiparesis at 19 hours after the injury. Computed tomography revealed cerebral infarct and angiography showed cervical ICA occlusion. Conservative therapy with hemodilution was given under a diagnosis of cervical ICA occlusion caused by extension and rotational head injury. Traumatic cervical ICA occlusion due to blunt injury is not uncommon in adults, but extremely rare in infants. We would like to emphasize the dangers of leaving a baby unattended in a carrier attached to a standing bicycle.

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Traumatic Thrombosis of the Internal Carotid Artery

Cited by 45 publications

References 8 publications

Injury of the basilar artery associated with closed head trauma

Injury of the basilar artery associated with closed head trauma

Non-penetrating trauma to the carotid artery with secondary thrombosis and embolism: Treatment by Thrombolysin

Traumatic Cervical Internal Carotid Artery Occlusion in an Infant-Case Report-

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