Cogbill T H, Sullivan H G
Department of Surgery, Gundersen Clinic, Ltd., La Crosse, WI 54601, USA.
J Trauma. 1995 Oct;39(4):763-7. doi: 10.1097/00005373-199510000-00030.
Arterial missile embolism is a rare complication of penetrating vascular trauma. We report a case of middle cerebral artery pellet embolism and delayed appearance of a carotid artery pseudoaneurysm following a shotgun wound of the neck. The pseudoaneurysm was repaired. Because the patient had no associated neurologic deficits, the pellet embolus was left within the patient middle cerebral artery. He remains well 4 years after injury. A selective approach to the management of a pellet embolus to the middle cerebral artery based on clinical signs or symptoms and status of arterial patency is recommended. In addition, several principles are suggested to improve the reliability of arteriography for shotgun wounds of the neck.
动脉弹丸栓塞是穿透性血管创伤的一种罕见并发症。我们报告一例颈部猎枪伤后大脑中动脉弹丸栓塞及延迟出现颈动脉假性动脉瘤的病例。对假性动脉瘤进行了修复。由于患者没有相关神经功能缺损，弹丸栓子留在患者大脑中动脉内。受伤4年后他情况良好。建议根据临床体征或症状以及动脉通畅情况，对大脑中动脉弹丸栓塞采取选择性治疗方法。此外，还提出了几项原则以提高颈部猎枪伤血管造影的可靠性。
