[Nonpenetrating brachiocephalic arterial injury]

The injury of brachiocephalic artery is uncommon in the blunt trauma and sometimes it was accompanied by other organ damages. We reported a case and reviewed 47 cases in literature. A 28-year-old woman was transferred to our hospital with the blunt chest trauma and the cerebral infarction due to the traffic accident. The cineangiogram showed complete obstruction at the middle portion of brachiocephalic artery and the subclavian steal-carotid recovery phenomenon. Thirty days after trauma, the operation was performed under the monitoring of right superficial temporal arterial pressure. The vessel with intimal defect was plugged by a clot and it was replaced with a Gore-Tex graft during simple occlusion of the right carotid, subclavian and brachiocephalic arteries without any monitoring pressure change. The postoperative course was uneventful and the symptom improved. The review decided that the main cause of the injury is traffic accidents and the cineangiogram is important to find the arterial damage and the monitoring of superficial temporal arterial pressure is helpful to avoid the brain ischemia during operation.