Injuries to the Neck

2016 ◽  
Author(s):  
Joseph M. Galante ◽  
Ian E Brown
Keyword(s):  
Vertebral Artery ◽  
Carotid Arteries ◽  
Cervical Vertebrae ◽  
Thyroid Cartilage ◽  
Penetrating Trauma ◽  
Sternocleidomastoid Muscle ◽  
External Carotid ◽  
Neck Trauma ◽  
Anterior Border ◽  
Blunt Cerebrovascular Injury

Approximately 5% of all cases of trauma involve injury to the neck. This relatively low incidence together with improvements in diagnostic modalities has led to continuing evolution in the management of neck trauma. Injuries to the neck can be the result of blunt and penetrating trauma. Both mechanisms can cause devastating injuries, with high associated morbidity and mortality. This review examines the airway, penetrating neck trauma, and blunt trauma. Figures show an algorithm outlining operative management of known or suspected injuries to the carotid arteries, jugular veins, pharynx, and esophagus, a tracheotomy hook used to retract the thyroid cartilage cephalad to facilitate placing the airway, the traditional division of the neck into three separate zones, exposure of structures in the anterior areas of the neck through an incision oriented along the anterior border of the sternocleidomastoid muscle,  dissection of the sternocleidomastoid muscle carried down to the level of the carotid sheath, a balloon embolectomy  catheter used to occlude the distal internal carotid artery at the skull base, a number of important structures encountered during distal dissection of the internal and external carotid arteries, options for repair of the arteries in the neck, exposure of the vertebral artery and the vertebral veins surrounded by the transverse processes of the cervical vertebrae, exposure of the distal vertebral artery via an incision along the anterior border of the sternocleidomastoid muscle, control of bleeding from vertebral artery injuries located within the transverse process of the cervical, approaching proximal vertebral artery via a supraclavicular incision, and an algorithm outlining management of known injuries to the vertebral artery, which are most often discovered by angiography. The table lists screening criteria for blunt cerebrovascular injury.   This review contains 13 highly rendered figures, 1 table, and 37 references

Injuries to the Neck

2015 ◽  
Author(s):  
Ian E Brown ◽  
Joseph M. Galante
Keyword(s):  
Vertebral Artery ◽  
Carotid Arteries ◽  
Cervical Vertebrae ◽  
Thyroid Cartilage ◽  
Penetrating Trauma ◽  
Sternocleidomastoid Muscle ◽  
External Carotid ◽  
Neck Trauma ◽  
Anterior Border ◽  
Blunt Cerebrovascular Injury

Approximately 5% of all cases of trauma involve injury to the neck. This relatively low incidence together with improvements in diagnostic modalities has led to continuing evolution in the management of neck trauma. Injuries to the neck can be the result of blunt and penetrating trauma. Both mechanisms can cause devastating injuries, with high associated morbidity and mortality. This review examines the airway, penetrating neck trauma, and blunt trauma. Figures show an algorithm outlining operative management of known or suspected injuries to the carotid arteries, jugular veins, pharynx, and esophagus, a tracheotomy hook used to retract the thyroid cartilage cephalad to facilitate placing the airway, the traditional division of the neck into three separate zones, exposure of structures in the anterior areas of the neck through an incision oriented along the anterior border of the sternocleidomastoid muscle,  dissection of the sternocleidomastoid muscle carried down to the level of the carotid sheath, a balloon embolectomy  catheter used to occlude the distal internal carotid artery at the skull base, a number of important structures encountered during distal dissection of the internal and external carotid arteries, options for repair of the arteries in the neck, exposure of the vertebral artery and the vertebral veins surrounded by the transverse processes of the cervical vertebrae, exposure of the distal vertebral artery via an incision along the anterior border of the sternocleidomastoid muscle, control of bleeding from vertebral artery injuries located within the transverse process of the cervical, approaching proximal vertebral artery via a supraclavicular incision, and an algorithm outlining management of known injuries to the vertebral artery, which are most often discovered by angiography. The table lists screening criteria for blunt cerebrovascular injury.   This review contains 13 highly rendered figures, 1 table, and 37 references

Injuries to the Neck

2015 ◽  
Author(s):  
David H. Wisner ◽  
Joseph M. Galante
Keyword(s):  
Vertebral Artery ◽  
Carotid Arteries ◽  
Life Support ◽  
Jugular Vein ◽  
Penetrating Trauma ◽  
Operative Management ◽  
Advanced Trauma Life Support ◽  
Neck Trauma ◽  
Anatomical Structures ◽  
Initial Management

Injuries to the neck can be the result of blunt and penetrating trauma. Both mechanisms can cause devastating injuries, with high associated rates of morbidity and mortality. Airway management in trauma does not differ based on the mechanism of injury, and so the initial priority is to ensure an adequate airway through cricothyrotomy or tracheotomy. For penetrating neck trauma, initial management is evaluated in accordance with Advanced Trauma Life Support (ATLS) guidelines. Thereafter, the management of penetrating trauma of the stable patients is provided and includes carotid artery exploration and repair, vertebral artery exploration and repair, endovascular repair, jugular vein injuries, treatment of the pharynx and esophagus, and treatment of the larynx and trachea. Blunt trauma is described and includes injuries to the aerodigestive tract and cerebrovascular and vertebral injuries. Figures show an algorithm outlining operative management of known or suspected injuries to the carotid arteries, jugular vein, pharynx, and esophagus; the three separate zones of the neck; common incisions made along the sternocleidomastoid muscle; important anatomical structures of the neck; and an algorithm outlining management of known injuries to the vertebral artery. This chapter contains 31 references.

scholarly journals A Rare Variantion of Left Vertebral Artery Originating from External Carotid Artery: A Case Report

2019 ◽  
Vol 4 (1) ◽  
Keyword(s):  
Carotid Artery ◽  
Vertebral Artery ◽  
Cervical Vertebrae ◽  
External Carotid Artery ◽  
Left Vertebral Artery ◽  
External Carotid ◽  
Transverse Foramen ◽  
Vertebral Arteries ◽  
Tomographic Angiography ◽  
Radiological Procedures

Variations of vertebral arteries are congenital anomalies occurring during the embryonic development. We established a variant left vertebral artery which is a branch of left external carotid artery, by using magnetic resonance angiography and computerized tomographic angiography in a 43-year-old female patient whose vertebral arteries could not be detected in Doppler ultrasonography performed for the evaluation of her dizziness. This vertebral artery was extending up outside the transverse foramina until it entered into the left transverse foramen of the cervical vertebrae at the C1 level. Awareness of such variations of vertebral arteries is important with regard to the prevention of possible cerebrovascular injuries in interventional radiological procedures and vascular surgeries. For this reason, we would like to present this rare case of left vertebral artery showing a different origin and course outside the transverse foramina.

External carotid-cavernous sinus fistula diagnosed by common carotid arteriography

1974 ◽  
Vol 41 (4) ◽  
pp. 494-498 ◽  
Author(s):  
Louis Wener ◽  
Giovanni Di Chiro ◽  
Robert A. Mendelsohn
Keyword(s):  
Cavernous Sinus ◽  
Carotid Arteries ◽  
External Carotid ◽  
Carotid Cavernous Fistula ◽  
Content Type ◽  
Cavernous Fistula ◽  
Carotid Cavernous Sinus Fistula ◽  
The Difference ◽  
Fine Print

✓ An external carotid-cavernous fistula diagnosed by serial common carotid arteriography is reported. The diagnosis was reached on the basis of the difference in time between filling of the distal internal and external carotid arteries and the visualization of the fistula.

scholarly journals Variations in the Branching Pattern of External Carotid Artery in South Kerala Population – A Cadaveric Study

2021 ◽  
Vol 8 (22) ◽  
pp. 1780-1785
Author(s):  
Manju Sudhakaran ◽  
Mini Alikunju ◽  
Vandana Latha Raveendran ◽  
Umesan Kannanvilakom Govindapillai
Keyword(s):  
Carotid Artery ◽  
Head And Neck ◽  
Carotid Arteries ◽  
Carotid Bifurcation ◽  
External Carotid Artery ◽  
External Carotid ◽  
Superior Thyroid Artery ◽  
South Indian Population ◽  
Branching Pattern ◽  
South Indian

BACKGROUND External carotid arteries account for a major share of arterial supply of head and neck regions. As variations are frequently observed in the branching pattern of external carotid artery, surgeons, radiologists and anaesthetists often encounter difficulties in various procedures of head and neck. The purpose of this study is to describe the variations in the branching pattern of external carotid artery as observed in South Indian population which definitely reduces its iatrogenic injuries associated with surgical and radiological procedures of head and neck. METHODS This is cross-sectional descriptive study. Bilateral neck dissection was done on twenty-two formalin fixed cadavers to study the branching pattern of external carotid artery during a period of two years in the Department of Anatomy in Government Medical College, Alappuzha. Common carotid, external carotid and internal carotid arteries were dissected. All the branches of external carotid artery were traced and the variations were noted. The distance between carotid bifurcation and point of origin of individual branches of external carotid were measured and statistically analyzed. RESULTS In the present study along with normal branching pattern of external carotid artery, variations like origin of superior thyroid artery from common carotid artery and also from carotid bifurcation were seen. A common linguofacial trunk and direct origin of superior laryngeal artery from external carotid artery were also observed. CONCLUSIONS Prior knowledge of the variations will be helpful to surgeons and anaesthetists while dealing with these vessels during procedures of head and neck regions. KEYWORDS External Carotid Artery, Carotid Bifurcation, Superior Thyroid Artery, Linguofacial Trunk

scholarly journals Progressive cervicocranial arteriopathy with dilatations and stenoses: case report

2004 ◽  
Vol 62 (3b) ◽  
pp. 899-902 ◽  
Author(s):  
Adriana Bastos Conforto ◽  
Paulo Puglia Jr ◽  
Fábio Iuji Yamamoto ◽  
Milberto Scaff
Keyword(s):  
Vertebral Artery ◽  
Carotid Arteries ◽  
Fibromuscular Dysplasia ◽  
Internal Carotid ◽  
Left Vertebral Artery ◽  
Fusiform Aneurysm ◽  
Pathogenetic Mechanism ◽  
Pontine Infarction ◽  
The Right ◽  
Internal Carotid Arteries

We report the case of a 36 year-old woman who presented occlusion of a basilar artery fusiform aneurysm (FA) associated with pontine infarction, and two episodes of subarachnoid hemorrhage possibly due to arterial dissection. She also had asymptomatic FAs in the right middle cerebral and left internal carotid arteries. Over 5 years, lesions suggestive of fibromuscular dysplasia in the right vertebral artery and occlusion of the left vertebral artery were observed. This combination of lesions emphasizes the possibility of a common pathogenetic mechanism causing different degrees of media disruption in cervicocranial arteries.

scholarly journals Carotid artery stenting for patients with occipital–vertebral anastomosis

2018 ◽  
Vol 25 (2) ◽  
pp. 212-218
Author(s):  
Ryuichiro Kajikawa ◽  
Toshiyuki Fujinaka ◽  
Hajime Nakamura ◽  
Manabu Kinoshita ◽  
Takeo Nishida ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Vertebral Artery ◽  
High Intensity ◽  
Carotid Artery Stenting ◽  
Internal Carotid ◽  
External Carotid ◽  
Occipital Artery ◽  
Protection Method ◽  
Distal Internal Carotid Artery

Background and purpose We report the outcomes of carotid artery stenting for patients with angiographically visible occipital artery–vertebral artery anastomosis. Methods Among 47 consecutive patients who underwent carotid artery stenting from January 2007 to December 2010, seven patients for whom cerebral angiograms clearly showed occipital artery–vertebral artery anastomosis were selected. Four different protection methods were used: distal internal carotid artery protection; carotid flow reversal; seatbelt and airbag technique; and double protection method of protecting both the external and internal carotid artery. Results One patient with distal internal carotid artery protection showed a high-intensity lesion at the border of the upper thalamus, internal capsule and lateral ventricle wall after carotid artery stenting. The other patient with the double protection method did not show any high-intensity lesions on postoperative diffusion-weighted imaging in the vertebrobasilar territory. All seven patients with visible occipital artery–vertebral artery anastomosis showed ipsilateral vertebral artery severe stenosis or occlusion. Conclusion Large occipital artery–vertebral artery anastomosis may be a pathway for embolic materials during carotid artery stenting. External carotid artery protection is recommended for carotid artery stenting in such patients.

Sign in / Sign up

Export Citation Format

Share Document