Air in the carotid canal as a predictor of distal internal carotid artery laceration.
The authors describe a 25-year old patient with blunt trauma-induced bilateral, distal segment internal carotid artery (ICA) lacerations, resulting in a left-sided direct carotid-cavernous sinus fistula (CCF) and presenting with massive oronasal bleeding. The combination of severe oronasal bleeding, with air in the carotid canal should alarm the treating physician to the presence of a distal internal carotid artery laceration.
Buis
D R
DR
Department of Neurosurgery, VU University Medical Center, Amsterdam, The Netherlands. dr.buis@vumc.nl
Dirven
C M F
CM
van den Berg
R
R
Manoliu
R A
RA
Vandertop
W P
WP
D000063:Accidents, Traffic; D000328:Adult; D001642:Bicycling; D020212:Carotid Artery Injuries / Q000175:diagnosis / Q000209:etiology*; D002343:Carotid Artery, Internal / Q000473:pathology / Q000503:physiopathology; D002426:Cavernous Sinus / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D020785:Central Nervous System Vascular Malformations / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D002533:Cerebral Angiography; D004618:Embolism, Air / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D004621:Embolization, Therapeutic; D004844:Epistaxis / Q000209:etiology; D005147:Facial Bones / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology; D017809:Fatal Outcome; D016489:Head Injuries, Closed / Q000150:complications*; D006801:Humans; D022125:Lacerations / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D008297:Male; D009055:Mouth / Q000503:physiopathology; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology; D011237:Predictive Value of Tests; D019291:Skull Base / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D020205:Skull Fracture, Basilar / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure