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[Injuries of the large brain-feeding arteries].

A Laske1, E Bauer, L von Segesser

  • 1Departement für Chirurgie, Universitätsspital Zürich.

Schweizerische Medizinische Wochenschrift
|July 21, 1990
PubMed
Summary

Injuries to large supraaortic arteries are rare in severely injured patients but carry a high mortality rate (53%) and frequent neurological deficits. Prompt diagnosis and management are crucial for improving outcomes in carotid artery trauma.

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Area of Science:

  • Vascular surgery
  • Trauma surgery
  • Neurology

Context:

  • Severe trauma patients present a low incidence (0.58%) of large supraaortic artery injuries.
  • These injuries, encompassing both penetrating and non-penetrating mechanisms, result in significant morbidity and mortality.
  • Non-penetrating carotid artery injuries are particularly associated with neurological deficits due to thrombosis or stenosis.

Purpose:

  • To analyze the incidence, treatment, and outcomes of large supraaortic artery injuries in severely injured patients.
  • To evaluate the effectiveness of surgical interventions and non-invasive diagnostic methods like Duplex-Doppler scanning.
  • To identify prognostic factors influencing survival and neurological deficits in carotid artery trauma.

Summary:

  • A study of 2923 severely injured patients identified 17 cases of large supraaortic artery injuries, with an overall mortality of 53% and 75% of survivors experiencing persistent neurological deficits.

Related Experiment Videos

  • Penetrating carotid injuries had a 50% mortality with repair on admission, while non-penetrating injuries, especially extracranial ones, showed higher mortality (83% for occluded vs. 29% for non-occluded).
  • Duplex-Doppler scanning is essential for diagnosing blunt carotid artery trauma, and delayed reconstruction is recommended for established neurological deficits to avoid complications.

    • Impact:

    • Highlights the critical nature of supraaortic artery injuries in trauma patients.
    • Emphasizes the importance of early diagnosis and appropriate management strategies, including the role of Duplex-Doppler scanning.
    • Provides evidence-based recommendations for surgical intervention timing and techniques to improve patient outcomes and reduce neurological deficits.