Källerö K S, Björck C G, Bergqvist D
Acta Chir Scand. 1987 Feb;153(2):155-60.
Three cases of carotid artery injury following blunt cervical trauma are reported and the literature is reviewed. The condition carries high morbidity and mortality rates, due to occlusion of the internal carotid artery. The diagnosis is often delayed, as the symptoms of carotid injury frequently are mistakenly attributed to head injury. The insidious course, with neurologic deficit developing in an alert patient prior to lowering of consciousness, distinguishes blunt carotid artery injury from head injury. Aortic arch angiography is crucial for the diagnosis, and should be frequently performed in patients who have sustained blunt cervical trauma. Normal computed tomography of the brain does not exclude ischaemic cerebral infarction, visualization of which requires several days. Tomography of the neck following intravenous injection of contrast medium may be useful for demonstrating occlusion of the carotid artery. Heightened awareness of this injury is important for early diagnosis. Immediate revascularization may improve the poor prognosis.
本文报告了3例钝性颈部创伤后颈动脉损伤的病例，并对相关文献进行了综述。由于颈内动脉闭塞，该疾病的发病率和死亡率很高。诊断往往会延迟，因为颈动脉损伤的症状常常被误诊为头部损伤。隐匿的病程，即在意识降低之前警觉患者出现神经功能缺损，这将钝性颈动脉损伤与头部损伤区分开来。主动脉弓血管造影对诊断至关重要，对于遭受钝性颈部创伤的患者应经常进行。脑部计算机断层扫描正常并不能排除缺血性脑梗死，其显影需要数天时间。静脉注射造影剂后进行颈部断层扫描可能有助于显示颈动脉闭塞。提高对这种损伤的认识对于早期诊断很重要。立即进行血管重建可能会改善不良预后。
