Bilateral internal carotid and vertebral artery dissection after a horse-riding injury.
Blunt cerebrovascular injuries, defined as blunt injuries to the internal carotid or vertebral arteries, are uncommon and usually occur in victims of high-speed deceleration motor vehicle crashes. A blunt cerebrovascular injury after an equestrian accident is an extremely unusual presentation. In recent years, advances in screening and treatment with pharmacologic anticoagulation before the onset of neurologic symptoms have improved outcomes for these patients. Endovascular stenting and embolization, although unproven, offer a new potential approach for these complex injuries. We present a unique case of four-vessel blunt cerebrovascular injuries after a horse-riding injury that required multidisciplinary management.
Keilani
Zeid M
ZM
Department of Surgery, Ochsner Clinic Foundation, New Orleans, LA 70121, USA. zkeilani@ochsner.org
Berne
John D
JD
Agko
Mouchammed
M
D000818:Animals; D000925:Anticoagulants / Q000627:therapeutic use; D001265:Athletic Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D002545:Brain Ischemia / Q000209:etiology; D020215:Carotid Artery, Internal, Dissection / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D005260:Female; D006736:Horses; D006801:Humans; D018810:Magnetic Resonance Angiography; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015607:Stents; D020521:Stroke / Q000209:etiology; D013898:Thoracic Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D020217:Vertebral Artery Dissection / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors