[Traumatic extracranial carotico-juguler fistulation].
BACKGROUND
Extracranial caroticovenous fistulae, if left untreated, may cause stroke, cerebral edema, and high output cardiac failure and may present with oculofacial signs. In this study, 5 cases with extracranial arteriovenous fistulae who were diagnosed and surgically treated promptly after trauma are presented.


METHODS
Five patients with extracranial traumatic caroti-cojuguler fistulation underwent urgent surgery in our department. Their mean age was 32.4 (range: 27-38). Mean door to operating room time was 2.4 hours. One patient underwent arcus aortography due to a large hematoma in the mediastinum. One patient underwent arterial Doppler ultrasound examination. The remaining three patients were diagnosed via physical examination.


RESULTS
There were three gunshot and two stab wounds. The right common carotid artery was injured in three cases and left common carotid artery in two. There was no early or late mortality. Cross-clamp time was 14.3+/-4.7 minutes. There was no major bleeding. One patient developed ischemic stroke secondary to hypotension due to massive bleeding before surgery and was transferred to the Department of Neurology on the 5th postoperative day.


CONCLUSIONS
We suggest that as soon as the diagnosis of traumatic caroti-cojuguler fistula is made, a surgical approach is effective and safe and may prevent possible complications due to delayed diagnosis and treatment.
Yaşa
Haydar
H
Department of Cardiovascular Surgery, Atatürk Training and Research Hospital, Izmir, Turkey. hyasa20@yahoo.com
Gökalp
Orhan
O
Güneş
Tevfik
T
Unalp
Haluk Recai
HR
Adanir
Tayfun
T
Yetkin
Ufuk
U
Ozbek
Cengiz
C
Gürbüz
Ali
A
D000328:Adult; D001164:Arteriovenous Fistula / Q000175:diagnosis* / Q000601:surgery*; D020212:Carotid Artery Injuries / Q000601:surgery*; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000293:injuries* / Q000601:surgery*; D008297:Male; D016896:Treatment Outcome; D014948:Wounds, Gunshot; D014951:Wounds, Stab; D055815:Young Adult