Endovascular stent placement of cervical internal carotid artery dissection related to a seat-belt injury: a case report.
OBJECTIVE
The incidence of carotid artery dissection related to blunt injury is very low, but the mortality rate is high. Rapid diagnosis and proper treatments are discussed.


METHODS
A 48-year-old woman presented diplopia and pulsating tinnitus of the left ear. An angiography showed a carotid cavernous fistula (CCF) and dissection of the extra-cranial internal carotid artery (ICA). To treat the dissection, a self-expanding endovascular stent was used. She has been followed for 6 years without any event and the ICA is patent.


CONCLUSIONS
Prompt diagnosis without delay and intimate follow-up is the key for the treatment of a carotid injury. Those patients who exhibit cervical bruits and/or seat-belt signs should be examined aggressively. Angioplasty with stents is amenable for patients with traumatic carotid dissections requiring vascular reconstruction in the acute stage.
Department of Neurosurgery, Kinki University School of Medicine, Osakasayama, Japan. nakkan@neuro-s.med.kindai.ac.jp
N
N
Nakagawa
F
F
Akai
N
N
Fukawa
H
H
Yugami
A
A
Kimoto
S
S
Majima
M
M
Taneda
D000063:Accidents, Traffic; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D020215:Carotid Artery, Internal, Dissection / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D020216:Carotid-Cavernous Sinus Fistula / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation / Q000502:physiology; D005260:Female; D019416:Head Movements / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D012622:Seat Belts / Q000009:adverse effects*; D015607:Stents; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D014949:Wounds, Nonpenetrating