Marciani R D, Israel S
Department of Veterans Affairs Medical Center, Lexington, KY, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997 Jan;83(1):5-9. doi: 10.1016/s1079-2104(97)90082-2.
The purpose of this study was to review the clinical and diagnostic findings associated with blunt carotid artery injury, provide information related to clinical outcome, and report the findings of a retrospective study comparing patients with nonpenetrating and penetrating carotid artery injuries and the attendant facial injuries.
Twenty-one patients admitted to the hospital nonelectively with a subsequent diagnosis of penetrating (11 patients) or nonpenetrating (10 patients) carotid artery injuries were included in the study. Records were analyzed for demographic data, mechanism of injury and time to diagnosis, neurologic status, presence of facial injuries, and outcome.
Five patients had facial injuries associated with a blunt carotid artery abnormality; six patients had penetrating carotid wounds. Time from carotid injury by all mechanisms to diagnosis was 20 minutes to 12 hours (mean 4 hours). Seventeen patients survived their injury.
Patients with completely asymptomatic head injuries and severe closed-head injuries must be given careful initial evaluation and subsequent secondary evaluation. The relatively high frequency of facial injuries associated with blunt carotid injury should alert the maxillofacial surgeon to consider the diagnosis.
本研究的目的是回顾与钝性颈动脉损伤相关的临床和诊断结果，提供与临床结局相关的信息，并报告一项回顾性研究的结果，该研究比较了非穿透性和穿透性颈动脉损伤患者以及伴随的面部损伤情况。
本研究纳入了21例非选择性入院且随后诊断为穿透性（11例）或非穿透性（10例）颈动脉损伤的患者。分析记录中的人口统计学数据、损伤机制和诊断时间、神经状态、面部损伤情况及结局。
5例患者的面部损伤与钝性颈动脉异常相关；6例患者有穿透性颈动脉伤口。所有损伤机制导致的颈动脉损伤至诊断的时间为20分钟至12小时（平均4小时）。17例患者受伤后存活。
对于完全无症状的头部损伤和严重闭合性头部损伤患者，必须进行仔细的初始评估和后续二次评估。钝性颈动脉损伤相关面部损伤的相对高发生率应提醒颌面外科医生考虑该诊断。
