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因高处坠落导致婴儿颅外颈内动脉假性动脉瘤的外科治疗:一例罕见病例

Surgical Treatment of Extracranial Internal Carotid Artery Pseudoaneurysm in an Infant Due to Falling from Height: An Unusual Case.

作者信息

Ucaroglu Erhan Renan, Tahtabasi Mehmet

机构信息

Department of Cardiovascular Surgery, University of Health Sciences- Somalia Turkey Recep Tayyip Erdogan Education and Research Hospital, Mogadishu, Somalia.

Department of Radiology, University of Health Sciences- Somalia Turkey Recep Tayyip Erdogan Education and Research Hospital, Mogadishu, Somalia.

出版信息

Int Med Case Rep J. 2023 Oct 10;16:667-672. doi: 10.2147/IMCRJ.S433360. eCollection 2023.

Abstract

Pseudoaneurysms of the internal carotid artery (ICA) caused by non-penetrating trauma are extremely rare. Patients with ICA pseudoaneurysms may present with cerebral ischemia, cervical masses, neck swelling, hematoma, rupture, pain, or cranial nerve dysfunction. We present a case of a left ICA pseudoaneurysm that developed in a 7-month-old infant because of a fall from height. The patient developed left-sided neck swelling that caused severe airway obstruction and respiratory arrest. The patient was urgently intubated and underwent emergency surgery under general anesthesia to repair the defect in the left ICA. Primary repair was performed to treat the pseudoaneurysms. The pseudoaneurysm sac was not removed because it was complicated and had extended into the respiratory tract. The patient was extubated on the 2nd day and discharged on the 7th day without complications. Follow-up of the patient after two weeks was unremarkable. Extracranial ICA pseudoaneurysms should be identified in patients presenting with blunt trauma. Emergency surgery should be considered for patients with progressive pseudoaneurysms.

摘要

非穿透性创伤导致的颈内动脉假性动脉瘤极为罕见。颈内动脉假性动脉瘤患者可能出现脑缺血、颈部肿块、颈部肿胀、血肿、破裂、疼痛或颅神经功能障碍。我们报告一例7个月大婴儿因高处坠落导致左侧颈内动脉假性动脉瘤的病例。患者出现左侧颈部肿胀,导致严重气道梗阻和呼吸骤停。患者紧急插管并在全身麻醉下接受急诊手术,以修复左侧颈内动脉的缺损。对假性动脉瘤进行了一期修复。由于假性动脉瘤囊情况复杂且已延伸至呼吸道,未予切除。患者于术后第2天拔管,第7天出院,无并发症。两周后对患者进行随访,情况良好。对于有钝性创伤的患者,应识别其颅外颈内动脉假性动脉瘤。对于假性动脉瘤进展的患者,应考虑急诊手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7700/10576563/316f858855c7/IMCRJ-16-667-g0001.jpg

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