Treatment of acute traumatic internal carotid artery occlusion with extracranial-to-intracranial arterial bypass: case report.
Ligation of the cervical internal carotid artery resulted in an acute neurological deficit in the dominant hemisphere of a 35-year-old man who suffered a penetrating injury to the neck. Regional cerebral hypoperfusion was suspected because the ischemic symptoms occurred while the patient was fully heparinized. Immediate institution of a barbiturate coma, volume expansion, and placement of a high-flow extracranial-intracranial arterial bypass graft led to rapid recovery of hemispheric function. High-flow extracranial-intracranial bypass grafts appear to be indicated for the treatment of symptomatic cerebral ischemia in selected cases of acute ligation or occlusion of the extracranial carotid artery.
Andrews
B T
BT
Department of Neurological Surgery, San Francisco General Hospital, California.
D000328:Adult; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000601:surgery*; D002548:Cerebral Revascularization; D006801:Humans; D008297:Male