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European Radiology
Published in: European Radiology 8/2008

01-08-2008 | Vascular-Interventional

Cerebrovascular trauma

Authors: Timo Krings, Sasikhan Geibprasert, Pierre L. Lasjaunias

Published in: European Radiology | Issue 8/2008

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Abstract

Vascular injury of the head and neck region is a rare and often life-threatening complication of head or neck trauma and is due to two major pathomechanisms: penetrating or blunt trauma. Both the arterial and the venous site of the CNS vasculature can be involved, the latter one being often overlooked. Concerning arterial lesions, depending on how many layers of the arterial vessel are affected and on the spatial relationship to adjacent structures, dissections, false aneurysms or arteriovenous fistulae may develop. On the venous side, dural tears, compressive effects on pial veins and a deranged clotting system may lead to delayed venous thrombosis. In this review we describe clinical and imaging findings, as well as diagnostic and treatment strategies in these lesions.
Literature
1.
Biffl WL, Moore EE, Ryu RK, Offner PJ, Novak Z, Coldwell DM, Franciose RJ, Burch JM (1998) The unrecognized epidemic of blunt carotid arterial injuries: early diagnosis improves neurologic outcome. Ann Surg 228:462–470PubMedCrossRef
2.
Cothren CC, Moore EE, Ray CE Jr, Ciesla DJ, Johnson JL, Moore JB, Burch JM (2005) Screening for blunt cerebrovascular injuries is cost-effective. Am J Surg 190:845–849PubMed
3.
Miller PR, Fabian TC, Bee TK, Timmons S, Chamsuddin A, Finkle R, Croce MA (2001) Blunt cerebrovascular injuries: diagnosis and treatment. J Trauma 51:279–285, discussion 285–276PubMed
4.
Nedeltchev K, Baumgartner RW (2005) Traumatic cervical artery dissection. Front Neurol Neurosci 20:54–63PubMedCrossRef
5.
Risgaard O, Sugrue M, D’Amours S, Christey G, Smith K, Caldwell E, Lariviere C (2007) Blunt cerebrovascular injury: an evaluation from a major trauma centre. ANZ J Surg 77:686–689PubMedCrossRef
6.
Feiz-Erfan I, Horn EM, Theodore N, Zabramski JM, Klopfenstein JD, Lekovic GP, Albuquerque FC, Partovi S, Goslar PW, Petersen SR (2007) Incidence and pattern of direct blunt neurovascular injury associated with trauma to the skull base. J Neurosurg 107:364–369PubMedCrossRef
7.
Willis BK, Greiner F, Orrison WW, Benzel EC (1994) The incidence of vertebral artery injury after midcervical spine fracture or subluxation. Neurosurgery 34:435–441, discussion 441–432PubMedCrossRef
8.
Hasso AN, Lasjaunias PL, Thompson JR, Hinshaw DB (1979) Venous occlusions of the cavernous area - a complication of crushing fractures of the sphenoid bone. Radiology 132:375–379PubMed
9.
Zhao WY, Krings T, Alvarez H, Ozanne A, Holmin S, Lasjaunias P (2007) Management of spontaneous haemorrhagic intracranial vertebrobasilar dissection: review of 21 consecutive cases. Acta Neurochir (Wien) 149:585–596CrossRef
10.
Schievink WI (2001) Spontaneous dissection of the carotid and vertebral arteries. N Engl J Med 344:898–906PubMedCrossRef
11.
Bogousslavsky J, Despland PA, Regli F (1987) Spontaneous carotid dissection with acute stroke. Arch Neurol 44:137–140PubMed
12.
Scheid R, Zimmer C, Schroeter ML, Ballaschke O, von Cramon DY (2006) The clinical spectrum of blunt cerebrovascular injury. Neurologist 12:255–262PubMedCrossRef
13.
Yang ST, Huang YC, Chuang CC, Hsu PW (2006) Traumatic internal carotid artery dissection. J Clin Neurosci 13:123–128PubMedCrossRef
14.
Sturzenegger M (1995) Spontaneous internal carotid artery dissection: early diagnosis and management in 44 patients. J Neurol 242:231–238PubMedCrossRef
15.
16.
Hart RG, Easton JD (1983) Dissections of cervical and cerebral arteries. Neurol Clin 1:155–182PubMed
17.
18.
Friedman D, Flanders A, Thomas C, Millar W (1995) Vertebral artery injury after acute cervical spine trauma: rate of occurrence as detected by MR angiography and assessment of clinical consequences. AJR Am J Roentgenol 164:443–447, discussion 448–449PubMed
19.
Golueke P, Sclafani S, Phillips T, Goldstein A, Scalea T, Duncan A (1987) Vertebral artery injury–diagnosis and management. J Trauma 27:856–865PubMed
20.
Benninger DH, Gandjour J, Georgiadis D, Stockli E, Arnold M, Baumgartner RW (2007) Benign long-term outcome of conservatively treated cervical aneurysms due to carotid dissection. Neurology 69:486–487PubMedCrossRef
21.
Cothren CC, Moore EE, Biffl WL, Ciesla DJ, Ray CE Jr, Johnson JL, Moore JB, Burch JM (2004) Anticoagulation is the gold standard therapy for blunt carotid injuries to reduce stroke rate. Arch Surg 139:540–545, discussion 545–546PubMedCrossRef
22.
Joo JY, Ahn JY, Chung YS, Chung SS, Kim SH, Yoon PH, Kim OJ (2005) Therapeutic endovascular treatments for traumatic carotid artery injuries. J Trauma 58:1159–1166PubMed
23.
Lasjaunias P, Wuppalapati S, Alvarez H, Rodesch G, Ozanne A (2005) Intracranial aneurysms in children aged under 15 years: review of 59 consecutive children with 75 aneurysms. Childs Nerv Syst 21:437–450PubMedCrossRef
24.
Levy ML, Rezai A, Masri LS, Litofsky SN, Giannotta SL, Apuzzo ML, Weiss MH (1993) The significance of subarachnoid hemorrhage after penetrating craniocerebral injury: correlations with angiography and outcome in a civilian population. Neurosurgery 32:532–540PubMedCrossRef
25.
Jones RF, Terrell JC, Salyer KE (1967) Penetrating wounds of the neck: an analysis of 274 cases. J Trauma 7:228–237PubMed
26.
Chambers EF, Rosenbaum AE, Norman D, Newton TH (1981) Traumatic aneurysms of cavernous internal carotid artery with secondary epistaxis. AJNR Am J Neuroradiol 2:405–409PubMed
27.
Chen D, Concus AP, Halbach VV, Cheung SW (1998) Epistaxis originating from traumatic pseudoaneurysm of the internal carotid artery: diagnosis and endovascular therapy. Laryngoscope 108:326–331PubMedCrossRef
28.
Holmes B, Harbaugh RE (1993) Traumatic intracranial aneurysms: a contemporary review. J Trauma 35:855–860PubMedCrossRef
29.
Lee JP, Wang AD (1990) Epistaxis due to traumatic intracavernous aneurysm: case report. J Trauma 30:619–622PubMedCrossRef
30.
Schuster JM, Santiago P, Elliott JP, Grady MS, Newell DW, Winn HR (1999) Acute traumatic posteroinferior cerebellar artery aneurysms: report of three cases. Neurosurgery 45:1465–1467, discussion 1467–1468PubMedCrossRef
31.
32.
de Keizer R (2003) Carotid-cavernous and orbital arteriovenous fistulas: ocular features, diagnostic and hemodynamic considerations in relation to visual impairment and morbidity. Orbit 22:121–142PubMedCrossRef
33.
Taki W, Nakahara I, Nishi S, Yamashita K, Sadatou A, Matsumoto K, Tanaka M, Kikuchi H (1994) Pathogenetic and therapeutic considerations of carotid-cavernous sinus fistulas. Acta Neurochir (Wien) 127:6–14CrossRef
34.
Berenstein A, Lasjaunias P, TerBrugge KG (2004) Surgical Neuroangiography 2.1 Clinical and Endovascular Ttreatment Aspects in Adults. Berlin: Springer
35.
Buis DR, Dirven CM, van den Berg R, Manoliu RA, Vandertop WP (2006) Air in the carotid canal as a predictor of distal internal carotid artery laceration. Acta Neurochir (Wien) 148:1201–1203, discussion 1203CrossRef
36.
Kwon BJ, Han MH, Kang HS, Chang KH (2005) Endovascular occlusion of direct carotid cavernous fistula with detachable balloons: usefulness of 3D angiography. Neuroradiology 47:271–281PubMedCrossRef
37.
Luo CB, Chang FC, Wu HM, Chung WY (2007) Transcranial embolization of a transverse-sigmoid sinus dural arteriovenous fistula carried out through a decompressive craniectomy. Acta Neurochir (Wien) 149:197–200, discussion 200CrossRef
38.
Luo CB, Guo WY, Teng MM, Chang FC, Pan DH (2005) Embolization of arteriovenous fistula after radiosurgery for multiple cerebral arteriovenous malformations. Kaohsiung J Med Sci 21:571–577PubMed
39.
Archondakis E, Pero G, Valvassori L, Boccardi E, Scialfa G (2007) Angiographic follow-up of traumatic carotid cavernous fistulas treated with endovascular stent graft placement. AJNR Am J Neuroradiol 28:342–347PubMed
40.
Meier U, Gartner F, Knopf W, Klotzer R, Wolf O (1992) The traumatic dural sinus injury–a clinical study. Acta Neurochir (Wien) 119:91–93CrossRef
41.
Taha JM, Crone KR, Berger TS, Becket WW, Prenger EC (1993) Sigmoid sinus thrombosis after closed head injury in children. Neurosurgery 32:541–545, discussion 545–546PubMedCrossRef
42.
Kinal ME (1967) Traumatic thrombosis of dural venous sinuses in closed head injury. J Neurosurg 27:142–145
Metadata
Title
Cerebrovascular trauma
Authors
Timo Krings
Sasikhan Geibprasert
Pierre L. Lasjaunias
Publication date
01-08-2008
Publisher
Springer-Verlag
Published in
European Radiology / Issue 8/2008
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-008-0915-z

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