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Minör Travma ve Minör Semptomlarla Karotis Diseksiyonu

Year 2011, Volume: 2 Issue: 4, 51 - 53, 01.10.2011

Abstract

Giriş: Travmatik karotis diseksiyonu genç hastalarda görülen nadir ancak
önemli bir inme sebebidir. Tanı koymada yaşanacak gecikmekler
uzun süreli morbiditeye ve hatta ölüme sebep olabilir. Semptomların
ortaya çıkışı bazen haftalar sürebilir. Burada hafif şiddette bir travma
sonrası meydana gelen ve semptomların silik olduğu bir vakayı
tartışmaktayız.
Olgu: 31 yaşında kadın hasta kendi kullandığı araç ile şiddeti az olan
bir kazadan 2 saat sonra yürüyerek acil servise başvurdu. Herhangi
bir şikayeti olmadığı sadece kontrol amaçlı geldiğini belirten hastanın
fizik muayenesinde servikal paravertebral kaslar üzerinde hassasiyet
haricinde özellik yoktu. Sistemik ve nörolojik muayenesi normaldi.
Öyküde hiperekstansiyon-fleksiyon tarzında yaralanma tarif eden
hastanın geçici görme bulanıklığı yaşadığı öğrenildi. Bunun üzerine
çekilen BT anjiografide sağ internal karotis arterde diseksiyon tespit
edildi. Antikoagulasyon tedavisi sonrası komplikasyon gelişmeden
hasta taburcu edildi.
Tartışma/Sonuç: Karotis diseksiyonu künt serebrovasküler yaralanmalarda
vasküler görüntüleme yapılması kriterlerine uymayan vakalarda
da görülebilir. Erken tanı iyi nörolojik durum açısından önemlidir. Acil
servis hekimleri hafif şiddette baş boyun travmalarında hastanın semptom
ve bulguları silik de olsa yaralanma mekanizmasını göz önünde
bulundurmalı ve vasküler yaralanmalar için şüpheci olmalıdırlar.

References

  • Fuse T, Ichihasi T, Matuo N. Asymtomatic carotid artery dissection caused by blunt trauma. Neurol Med Chir 2008;48:22-5.
  • Baron BJ. Trauma to the Neck. In Judith E. Tintinalli, Editor. Tintinalli’s Emergency Medicine. 7th ed. New York: McGraw-Hill; 2011: p.1738-44.
  • Caplan LR. Dissections of brain-supplying arteries. Nat Clin Pract Neurol. 2008; 4: 34-42.
  • Yang ST, Huang YC, Chuang CC, Hsu PW. Traumatic internal carotid artery dissection. J Clin Neurosci 2006;13:123-8.
  • Zach V, Zhovtis S, Kirchoff-Torres KF, Weinberger JM. Common carotid artery disseciton: A case report and review of the literature. J Stroke Cerebrovasc Dis 2010; doi: 10:1016/j. jstrokecerebrovascdis.2010.05.001.
  • Cothren CC, Moore EE. Blunt cerebrovascular injuries. Clinics.2005;60:489-96.

Carotid Artery Dissection With Minor Trauma and Minor Symptoms

Year 2011, Volume: 2 Issue: 4, 51 - 53, 01.10.2011

Abstract

Introduction: Traumatic carotid artery dissection is a rare but significant cause of ischemic stroke in young population. The delay in the diagnosis may lead to life long morbidity or even death. Symptoms may be delayed to several weeks. We are presenting a case with right internal carotid artery dissection after a low velocity motor vehicle accident with minor nonspecific symptoms.Case: 31 year old woman came to the emergency room on foot, two hours after having a low velocity motor vehicle accident. She did not have any specific complaint. She described hyperextension-flexion injury and there was no direct trauma to head and neck. She had mild tenderness over right cervical paravertebral muscles. Systemic and neurological examination was normal. Cranial and Cervical CT scans were normal. CT angiography revealed dissection of the right internal carotid artery. No complication was observed after anticoagulation.Discussion/Conclusion: Carotid artery dissection may not always fulfill the screening criteria for blunt cerebrovascular injury. Emergency physicians should be suspicious about the vascular pathologies for all head and neck injuries. The most important clue is the injury mechanism. Detailed history must be obtained and patients should be asked in terms of transient symptoms

References

  • Fuse T, Ichihasi T, Matuo N. Asymtomatic carotid artery dissection caused by blunt trauma. Neurol Med Chir 2008;48:22-5.
  • Baron BJ. Trauma to the Neck. In Judith E. Tintinalli, Editor. Tintinalli’s Emergency Medicine. 7th ed. New York: McGraw-Hill; 2011: p.1738-44.
  • Caplan LR. Dissections of brain-supplying arteries. Nat Clin Pract Neurol. 2008; 4: 34-42.
  • Yang ST, Huang YC, Chuang CC, Hsu PW. Traumatic internal carotid artery dissection. J Clin Neurosci 2006;13:123-8.
  • Zach V, Zhovtis S, Kirchoff-Torres KF, Weinberger JM. Common carotid artery disseciton: A case report and review of the literature. J Stroke Cerebrovasc Dis 2010; doi: 10:1016/j. jstrokecerebrovascdis.2010.05.001.
  • Cothren CC, Moore EE. Blunt cerebrovascular injuries. Clinics.2005;60:489-96.
There are 6 citations in total.

Details

Other ID JA29GV39KM
Journal Section Case Report
Authors

Tuba Cimilli Öztürk This is me

Serpil Yaylacı This is me

Şebnem Eren Çevik This is me

Onur Yeşil This is me

Özlem Güneysel

Publication Date October 1, 2011
Submission Date October 1, 2011
Published in Issue Year 2011 Volume: 2 Issue: 4

Cite

APA Öztürk, T. C., Yaylacı, S., Çevik, Ş. E., Yeşil, O., et al. (2011). Carotid Artery Dissection With Minor Trauma and Minor Symptoms. Journal of Emergency Medicine Case Reports, 2(4), 51-53.
AMA Öztürk TC, Yaylacı S, Çevik ŞE, Yeşil O, Güneysel Ö. Carotid Artery Dissection With Minor Trauma and Minor Symptoms. Journal of Emergency Medicine Case Reports. October 2011;2(4):51-53.
Chicago Öztürk, Tuba Cimilli, Serpil Yaylacı, Şebnem Eren Çevik, Onur Yeşil, and Özlem Güneysel. “Carotid Artery Dissection With Minor Trauma and Minor Symptoms”. Journal of Emergency Medicine Case Reports 2, no. 4 (October 2011): 51-53.
EndNote Öztürk TC, Yaylacı S, Çevik ŞE, Yeşil O, Güneysel Ö (October 1, 2011) Carotid Artery Dissection With Minor Trauma and Minor Symptoms. Journal of Emergency Medicine Case Reports 2 4 51–53.
IEEE T. C. Öztürk, S. Yaylacı, Ş. E. Çevik, O. Yeşil, and Ö. Güneysel, “Carotid Artery Dissection With Minor Trauma and Minor Symptoms”, Journal of Emergency Medicine Case Reports, vol. 2, no. 4, pp. 51–53, 2011.
ISNAD Öztürk, Tuba Cimilli et al. “Carotid Artery Dissection With Minor Trauma and Minor Symptoms”. Journal of Emergency Medicine Case Reports 2/4 (October 2011), 51-53.
JAMA Öztürk TC, Yaylacı S, Çevik ŞE, Yeşil O, Güneysel Ö. Carotid Artery Dissection With Minor Trauma and Minor Symptoms. Journal of Emergency Medicine Case Reports. 2011;2:51–53.
MLA Öztürk, Tuba Cimilli et al. “Carotid Artery Dissection With Minor Trauma and Minor Symptoms”. Journal of Emergency Medicine Case Reports, vol. 2, no. 4, 2011, pp. 51-53.
Vancouver Öztürk TC, Yaylacı S, Çevik ŞE, Yeşil O, Güneysel Ö. Carotid Artery Dissection With Minor Trauma and Minor Symptoms. Journal of Emergency Medicine Case Reports. 2011;2(4):51-3.