Transection of the Common Carotid and Vertebral Arteries Following a Penetrating Neck Injury

A case of a 30-year-old man who was admitted following a penetrating neck injury is presented. A clinical examination and operative findings identified semi-comatose mentality, neck muscle laceration, and transection of the left common carotid and vertebral arteries and the internal jugular vein. During the operation, the carotid arteries were repaired by interposition grafting, and the internal jugular vein was ligated. The vertebral artery was managed by interventional embolization. Although the patient had some neurological deficit, he was discharged on postoperative Day 52. This surgical case prompted a discussion regarding neurological outcomes, and surgical and endovascular treatment following vascular neck injury.

Possibilities of Magnetic Resonance Imaging in the Diagnosis of Changes in the «Vascular Wall» in Giant Cell Arteritis

The aim of the study: to identify features of extracranial carotid and vertebral arteries vessel wall MRI in norm and pathology using layer-by-layer analysis of the arterial wall components. MRI results were compared at the same anatomical level with data of ultrasound examination of vertebral arteries in patients with giant cell arteritis and in health individuals. It was revealed that in normal arteries MRI signal from the vessel wall mainly formed by vascularized adventitia and venous plexuses. Media and intima visualization becomes possible in cases of their pathological transformation. Thus, it was defined which structures of the vessel wall take part in MRI signal forming in health individuals and patient with pathology. Also MRI patterns of different stages of large arteries vasculitis were identified.

Endovascular Considerations in Traumatic Injury of the Carotid and Vertebral Arteries

Cervical carotid and vertebral artery traumatic injuries can have a devastating natural history. This article reviews the epidemiology, mechanisms of injury, clinical presentation, and classification systems pertinent to consideration of endovascular treatment. The growing role of modern endovascular techniques for the treatment of these diseases is presented to equip endovascular surgeons with a framework for critically assessing patients presenting with traumatic cervical cerebrovascular injury.

Spontaneous dissection of bilateral internal carotid and vertebral arteries

Spontaneous dissection of the major arteries of the neck is known to increase the risk of stroke or transient ischaemic attack in young and middle-aged adults. Most of the reported cases of arterial dissections in the neck involve one or both paired extracranial carotid or vertebral arteries. Spontaneous dissection of the bilateral internal carotid and vertebral arteries is extremely rare. We report a case of spontaneous bilateral internal carotid artery and vertebral artery dissection while using a prescribed pill for weight loss which contained amphetamine derivative. A review of literature is also provided.

Carotid endarterectomy as the treatment of choice for clearing the internal carotid artery in transitional ischemic attacks

Introduction: TIAs are ischemia, caused by stenosis of the carotid and vertebral arteries. Those who have a TIA are at risk of ischemic stroke and myocardial infarction, with carotid endarterectomy being an intervention. Objective: To analyze the benefits of carotid endarterectomy using drugs. Methods: Literature review, in bases such as PUBMED, MEDLINE, descriptors: “Endarterectomy”, “Ischemic Attack”, with operator “AND” and “OR”. Those with two descriptors were selected in the summary and date between 2010-2020, English / Portuguese language, resulting in: 17 articles. Results: The internal carotid artery (ICA) is located in the neck as a branch of the common carotid artery, being one of its branches the middle cerebral artery (MCA), the main artery affected in strokes and TIAs. Thus, ACI ischemia causes a risk of thrombosis in MCA, the treatment of carotid stenosis requires drugs to prevent atheroma, as well as antiplatelet drugs to reduce embolic events¹. In some cases, carotid endarterectomy or carotid stent implantation is complementary. Therefore, patients with TIA or stroke, who have “transient, fluctuating or persistent unilateral motor weakness or speech disorder or eye symptoms”, should undergo endarterectomy if they have moderate-severe stenosis of the extracranial internal carotid artery in the first days of presentation². Thus, endarterectomy is the treatment of choice and stenting should only be offered to symptomatic patients. Conclusion: Therefore, endarterectomy has been shown to be safe for patients with internal carotid artery stenosis, indicating the prevalence in relation to the stent.