Arai H, Kiyoshi F, Onuma T
Department of Neurosurgery, Sendai City Hospital.
No Shinkei Geka. 1992 Sep;20(9):991-5.
An eighty-year-old man slipped in the bathroom and received a deep slash wound in his left neck caused by a broken fragment of the bathroom door. A fragment of the glass stuck into his left neck. He was carried to our clinic after 20 minutes in a state of shock and showed right hemiparesis and aphasia. Following immediate orotracheal intubation and emergent therapy for shock, he was transferred to the operation theater for massive arterial bleeding from the wound. The left common carotid artery and internal jugular vein were exposed by extending the skin incision from the cervical wound along the anterior border of the left sternocleidomastoideus. The left common carotid artery and the internal jugular vein were simultaneously transected, and end-to-end anastomosis of the carotid artery was performed under the administration of 300 ml of Sendai Cocktail. The occlusion time of the left common carotid artery was approximately 50 minutes. Right hemiparesis and total aphasia did not change immediately after the surgery. The postsurgical CT scan showed an infarction in the posterior portion of the left middle and posterior cerebral arteries. However, after undergoing rehabilitation for a month, the patient could walk alone, and his aphasia improved. Many large series of penetrating injuries to the carotid artery were reported after World War II. Most casualties were younger males injured by gunshot. In middle cervical injury, the common carotid artery is the most vulnerable vessel, although other large vessels such as the external and internal carotid arteries as well as the internal jugular vein may be involved, often causing neurological deficits and shock.(ABSTRACT TRUNCATED AT 250 WORDS)
一名80岁男性在浴室滑倒，被浴室门的破碎碎片割伤左颈部，造成一处很深的伤口。一块玻璃碎片扎入他的左颈部。20分钟后，他在休克状态下被送至我们诊所，表现出右侧偏瘫和失语。在立即进行经口气管插管和抗休克紧急治疗后，他被转至手术室，因伤口大量动脉出血。沿颈部伤口并沿着左胸锁乳突肌前缘延长皮肤切口，暴露左颈总动脉和颈内静脉。同时横断左颈总动脉和颈内静脉，在输注300毫升仙台混合液的情况下进行颈动脉端端吻合术。左颈总动脉的阻断时间约为50分钟。术后右侧偏瘫和完全失语并未立即改善。术后CT扫描显示左大脑中动脉和大脑后动脉后部梗死。然而，经过一个月的康复治疗后，患者能够独自行走，失语症状也有所改善。第二次世界大战后报告了许多颈动脉穿透伤的大系列病例。大多数伤亡者是受枪伤的年轻男性。在颈部中段损伤中，颈总动脉是最易受损的血管，尽管其他大血管如颈外动脉、颈内动脉以及颈内静脉也可能受累，常导致神经功能缺损和休克。（摘要截断于250字）
