Zagazig University Medical Journal


Background: Blunt cerebrovascular injury (BCVI) describes a spectrum of carotid arterial intimal injuries. It may cause dissection of the common carotid artery, which may evolve into a pseudoaneurysm in up to 30% of patients. The aim of this work was to study blunt trauma of the extracranial carotid arteries and its operative management.Methods: Twenty one patients with blunt trauma of the extracranial carotid arteries were included; 19 patients presented with pseudoaneurysms, one patient presented with grade I irregularity of the blood vessel and one patient presented with carotid internal jugular fistula. Types of surgery were: Direct excision of the pseudoaneurysm and lateral repair, or patch graft. Excision and primary end to end anastomosis or excision and interposition graft. Carotid internal jugular fistula was treated by separation of the fistula and lateral repair of the artery and vein. Results: Twenty one patients with blunt trauma to the neck, 14 were males (66.67%) and 7 were females (33.33%).The main cause of injury was road motor vehicle in (57.14%) of cases. Surgical interventions were done in (95.24%) of cases. The main indication of surgery was pseudoaneurysm in (90.48%) of cases. Wound sepsis was the main complication of surgery in (14.28%) of cases. Conclusions: Trauma to the neck may result in blood vessel injury, arterial pseudoaneurysms. It should be diagnosed and treated due to its high risk of morbidity and mortality. Open surgical reconstruction of the carotid artery after excision of the pseudoaneurysm was effective and safe with less major neurologic complications.



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