title: Survival with intact cerebral function after gunshot injury to both internal carotid arteries.
abstract: A 24-year-old man was admitted after sustaining a single gunshot wound to the neck with an expanding hematoma on the left. Computed tomography angiography demonstrated bilateral internal carotid artery pseudoaneurysms, with disruption of flow on the left and a carotid-jugular fistula on the right. At operation, transection of the left internal carotid artery necessitated ligation of the artery. No injuries to the trachea or larynx were found, but the pharynx was lacerated and was repaired. The patient was transferred to the angiography suite where a stent graft was placed in the right internal carotid artery. This served to close the pseudoaneurysm and the arteriovenous fistula while preserving distal flow. The patient recovered with intact cerebral function and with mild paresis of the tongue related to hypoglossal nerve injury. He was discharged home after 7 days.
authors.affiliation: Department of Vascular Surgery, Tel Aviv Sourasky Medical Center, Israel.
authors.forename: Yefim
authors.initials: Y
authors.lastname: Rabinovich
authors.forename: David
authors.initials: D
authors.lastname: Samuels
authors.forename: Laszlo
authors.initials: L
authors.lastname: Zelmanovich
authors.forename: Avi
authors.initials: A
authors.lastname: Khafif
authors.forename: Evgeny
authors.initials: E
authors.lastname: Reider
authors.forename: Yehuda G
authors.initials: YG
authors.lastname: Wolf
mesh_terms: D000328:Adult; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D020212:Carotid Artery Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery*; D002533:Cerebral Angiography; D006801:Humans; D061228:Hypoglossal Nerve Injuries; D008297:Male; D019838:Neck Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014948:Wounds, Gunshot