Abstract
A 13-year-old boy was transferred to our trauma center after sustaining a shotgun
wound to his neck and head. Workup revealed an injury to his tonsillar fossa, a pseudoaneurysm
less than 4 mm in his internal carotid artery, and diffuse cerebral edema. After management
of his intracranial hypertension, follow-up angiogram revealed 4 pseudoaneurysms in
his internal carotid artery. In the operating room, the affected segment was resected,
and a transposition of the external carotid artery to the internal carotid artery
was performed. Workup of penetrating neck trauma and management options for internal
carotid artery pseudoaneurysms in a pediatric patient are discussed.
Key words
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References
- Management of penetrating injuries to carotid artery.World J Surg. 2001; 25: 1028-1035
- Clinical practice guideline: penetrating zone II neck trauma.J Trauma. 2008; 64: 1392-1405
- Penetrating neck injuries: helical CT angiography for initial evaluation.Radiology. 2002; 224: 366-372
- Prospective evaluation of screening multislice helical computed tomographic angiography in the initial evaluation of penetrating neck injuries.J Trauma. 2006; 61: 144-149
- Gunshot wounds of the internal carotid artery at the skull base: management with vein bypass grafts and a review of the literature.J Trauma. 1997; 42: 123-132
- Endovascular-covered stent treatment of posttraumatic cervical carotid artery pseudoaneurysms.Australas Radiol. 2004; 48: 220-223
- Current trends in the management of iatrogenic cervical carotid artery injuries.Vasc Endovascular Surg. 2006; 40: 354-361
- A prospective study of the clinical outcome of femoral pseudoaneurysms and arteriovenous fistulas induced by arterial puncture.J Vasc Surg. 1993; 17 ([discussion 31-3]): 125-131
- Anticoagulation is the gold standard therapy for blunt carotid injuries to reduce stroke rate.Arch Surg. 2004; 139 ([discussion 5-6]): 540-545
- Protected carotid-artery stenting versus endarterectomy in high-risk patients.N Engl J Med. 2004; 351: 1493-1501
- Antithrombotic therapy and endovascular stents are effective treatment for blunt carotid injuries: results from longterm followup.J Am Coll Surg. 2007; 204 ([discussion 14-5]): 1007-1013
- Carotid artery stents for blunt cerebrovascular injury: risks exceed benefits.Arch Surg. 2005; 140 ([discussion 5-6]): 480-485
- Vascular trauma and reconstructive approaches.Semin Pediatr Surg. 1994; 3: 124-132
- Pediatric renovascular hypertension: a thirty-year experience of operative treatment.J Vasc Surg. 1995; 21 ([discussion 26-7]): 212-226
- Renal artery intervention in pediatric and adolescent patients: a 20-year experience.Vasc Endovascular Surg. 2007; 41: 490-499
- Fate of 100 aortorenal vein grafts: characteristics of late graft expansion, aneurysmal dilatation, and stenosis.Surgery. 1973; 74: 931-944
Article info
Publication history
Accepted:
November 28,
2008
Received in revised form:
November 25,
2008
Received:
October 15,
2008
Identification
Copyright
© 2009 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
