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.
Nakagawa
N
N
Department of Neurosurgery, Kinki University School of Medicine, Osakasayama, Japan. nakkan@neuro-s.med.kindai.ac.jp
Akai
F
F
Fukawa
N
N
Yugami
H
H
Kimoto
A
A
Majima
S
S
Taneda
M
M
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