Englund R, Harris J P, May J
Vascular Surgical Service, Royal Prince Alfred Hospital, Sydney, Australia.
Ann Vasc Surg. 1988 Oct;2(4):362-6. doi: 10.1016/S0890-5096(06)60817-0.
Blunt injury of the internal carotid artery is rare and easily overlooked. The injury should be considered in a conscious patient with dense neurological deficit after blunt trauma to the head and neck. The diagnosis was established in 17 patients (9 men, 8 women) by arteriography. There was a median delay of 19 hours in the onset of neurologic deficit in 15 patients. Follow up arteriography was obtained in 16 of the 17 patients with a median interval of three months between arteriograms. On repeat arteriography, the internal carotid artery was patent in three of the nine patients with internal carotid arteries occluded on initial arteriography. Surgical repair was attempted in six patients. No significant difference in long term neurological deficit occurred between patients treated conservatively and those treated operatively. Of the 15 patients with hemiparesis on presentation, eight made a complete recovery and six improved. This study supports nonoperative management for blunt injuries of the internal carotid artery.
颈内动脉钝性损伤较为罕见且易被忽视。对于头部和颈部遭受钝性创伤后出现严重神经功能缺损的清醒患者，应考虑存在该损伤。通过动脉造影确诊了17例患者（9例男性，8例女性）。15例患者神经功能缺损症状出现的中位延迟时间为19小时。17例患者中的16例进行了随访动脉造影，两次动脉造影片之间的中位间隔时间为三个月。在重复动脉造影时，最初动脉造影显示颈内动脉闭塞的9例患者中有3例颈内动脉通畅。6例患者尝试进行了手术修复。保守治疗患者和手术治疗患者在长期神经功能缺损方面无显著差异。就诊时存在偏瘫的15例患者中，8例完全康复，6例有所改善。本研究支持对颈内动脉钝性损伤采取非手术治疗。
