Semin intervent Radiol 2003; 20(2): 125-140
DOI: 10.1055/s-2003-43317
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Emergency Evaluation and Treatment of Injury to the Extracranial Carotid and Vertebral Arteries

M. J. Bernadette Stallmeyer1 , Gregg H. Zoarski2 , Adam Gittleman3 , A. Orlando Ortiz3 , Abraham Obuchowski2
  • 1Assistant Professor of Diagnostic Radiology, Department of Radiology, University of Maryland Medical Center, Baltimore, Maryland
  • 2Department of Radiology, University of Maryland Medical Center, Baltimore, Maryland
  • 3Department of Radiology, Winthrop-University Hospital, Mineola, New York
Further Information

Publication History

Publication Date:
31 October 2003 (online)

ABSTRACT

This article describes the evaluation and treatment of injuries to the carotid and vertebral arteries. The diagnosis of the injured vessels by clinical and imaging methods is described. A variety of treatments including the use of stents is given.

REFERENCES

  • 1 Yamada S, Kindt G W, Youmans J R. Carotid artery occlusion due to nonpenetrating injury.  J Trauma . 1967;  7 333-342
  • 2 Krajewski L P, Hertzer N R. Blunt carotid artery trauma: report of two cases and review of the literature.  Ann Surg . 1980;  191 341-346
  • 3 Perry M O, Snyder W H, Thal E R. Carotid artery injuries caused by blunt trauma.  Ann Surg . 1980;  192 74-77
  • 4 Davis J W, Holbrook T L, Hoyt D B. et al . Blunt carotid artery dissection: incidence, associated injuries, screening, and treatment.  J Trauma . 1990;  30 1514-1517
  • 5 Martin R F, Eldrup-Jorgensen J, Clark D E, Bredenberg C E. Blunt trauma to the carotid arteries.  J Vasc Surg . 1991;  14 789-795
  • 6 Cogbill T H, Moore E E, Meissner M. et al . The spectrum of blunt injury to the carotid artery: a multicenter perspective.  J Trauma . 1994;  37 473-479
  • 7 Ramadan F, Rutledge R, Oller D. et al . Carotid artery trauma: a review of contemporary trauma center experiences.  J Vasc Surg . 1995;  21 46-56
  • 8 Carrillo E H, Osborne D L, Spain D A. et al . Blunt carotid artery injuries: difficulties with the diagnosis prior to neurologic event.  J Trauma . 1999;  46 1120-1125
  • 9 Kraus R R, Bergstein J M, DeBord J R. Diagnosis, treatment, and outcome of blunt carotid arterial injuries.  Am J Surg . 1999;  178 190-193
  • 10 Miller P R, Fabian T C, Bee T K. et al . Blunt cerebrovascular injuries: diagnosis and treatment.  J Trauma . 2001;  51 279-286
  • 11 Biffl W L, Moore E E, Elliott J P. et al . The devastating potential of blunt vertebral arterial injuries.  Ann Surg . 2000;  231 672-681
  • 12 Bok A P, Peter J C. Carotid and vertebral artery occlusion after blunt cervical injury: the role of MR angiography in early diagnosis.  J Trauma . 1996;  40 968-972
  • 13 Giacobetti F B, Vaccaro A R, Bos-Giacobetti M A. et al . Vertebral artery occlusion associated with cervical spine trauma. A prospective analysis.  Spine . 1997;  22 188-192
  • 14 Biffl W L, Moore E E, Ryu R K. et al . The unrecognized epidemic of blunt carotid arterial injuries: early diagnosis improves neurologic outcome.  Ann Surg . 1998;  228 462-470
  • 15 Biffl W L, Moore E E, Offner P J. et al . Blunt carotid arterial injuries: implications of a new grading scale.  J Trauma . 1999;  47 845-853
  • 16 Prall J A, Brega K E, Coldwell D M, Breeze R E. Incidence of unsuspected blunt carotid artery injury.  Neurosurgery . 1998;  42 495-499
  • 17 Rogers F B, Baker E F, Osler T M. et al . Computed tomographic angiography as a screening modality for blunt cervical arterial injuries: preliminary results.  J Trauma . 1999;  46 380-385
  • 18 Welling R E, Saul T G, Tew Jr M J. et al . Management of blunt injury to the internal carotid artery.  J Trauma . 1987;  27 1221-1226
  • 19 Kerwin A J, Bynoe R P, Murray J. et al . Liberalized screening for blunt carotid and vertebral artery injuries is justified.  J Trauma . 2001;  51 308-314
  • 20 Biffl W L, Ray Jr E C, Moore E E. et al . Treatment-related outcomes from blunt cerebrovascular injuries: importance of routine follow-up arteriography.  Ann Surg . 2002;  235 699-707
  • 21 Fabian T C, Patton Jr H J, Croce M A. et al . Blunt carotid injury. Importance of early diagnosis and anticoagulant therapy.  Ann Surg . 1996;  223 513-525
  • 22 Alimi Y, Di Mauro P, Tomachot L. et al . Bilateral dissection of the internal carotid artery at the base of the skull due to blunt trauma: incidence and severity.  Ann Vasc Surg . 1998;  12 557-565
  • 23 Parenti G, Orlandi G, Bianchi M. et al . Vertebral and carotid artery dissection following chiropractic cervical manipulation.  Neurosurg Rev . 1999;  22 127-129
  • 24 Lannuzel A, Moulin T, Amsallem D. et al . Vertebral-artery dissection following a judo session: a case report.  Neuropediatrics . 1994;  25 106-108
  • 25 Tramo M J, Hainline B, Petito F. et al . Vertebral artery injury and cerebellar stroke while swimming: case report.  Stroke . 1985;  16 1039-1042
  • 26 Rogers L, Sweeney P J. Stroke: a neurologic complication of wrestling. A case of brainstem stroke in a 17-year-old athlete.  Am J Sports Med . 1979;  7 352-354
  • 27 Traflet R F, Babaria A F, Bell R D. et al . Vertebral artery dissection after rapid head turning.  AJNR Am J Neuroradiol . 1989;  10 650-651
  • 28 Egnor M R, Page L K, David C. Vertebral artery aneurysm-a unique hazard of head banging by heavy metal rockers. Case Report.  Pediatr Neurosurg. 1991-92;  17 135-138
  • 29 Mokri B, Sundt Jr M T, Houser O W. Spontaneous internal carotid dissection, hemicrania, and Horner's syndrome.  Arch Neurol . 1979;  36 677-680
  • 30 Hart R G, Easton J D. Dissections of cervical and cerebral arteries.  Neurol Clin . 1983;  1 155-182
  • 31 Schievink W I. Spontaneous dissection of the carotid and vertebral arteries.  N Engl J Med . 2001;  344 898-906
  • 32 Schievink W I, Bjornsson J, Piepgras D G. Coexistence of fibromuscular dysplasis and cystic medial necrosis in a patient with Marfan's syndrome and bilateral carotid artery dissections.  Stroke . 1994;  25 2492-2496
  • 33 Schievink W I, Michels V V, Piepgras D G. Neurovascular manifestations of heritable connective tissue disorders. A review.  Stroke . 1994;  25 889-903
  • 34 Mokri B, Sundt Jr M T, Houser O W, Piepgras D G. Spontaneous dissection of the cervical internal carotid artery.  Ann Neurol . 1986;  19 126-138
  • 35 Harris J P, Horlbeck D M, Brew K H. Unique case of pulsatile tinnitus.  Ann Otol Rhinol Laryngol . 2000;  109 1103-1106
  • 36 Mokri B, Schievink W I, Olsen K D, Piepgras D G. Spontaneous dissection of the cervical internal carotid artery. Presentation with lower cranial nerve palsies.  Arch Otolaryngol Head Neck Surg . 1992;  118 431-435
  • 37 Schievink W I, Mokri B, Garrity J A. et al . Ocular motor nerve palsies in spontaneous dissections of the cervical internal carotid artery.  Neurology . 1993;  43 1938-1941
  • 38 Mokri B, Silbert P L, Schievink W I, Piepgras D G. Cranial nerve palsy in spontaneous dissection of the extracranial internal carotid artery.  Neurology . 1996;  46 356-359
  • 39 Zetterling M, Carlstrom C, Konrad P. Internal carotid artery dissection.  Acta Neurol Scand . 2000;  101 1-7
  • 40 Fabian T C, George Jr M S, Croce M A. et al . Carotid artery trauma: management based on mechanism of injury.  J Trauma . 1990;  30 953-963
  • 41 Saeed A B, Shuaib A, Al-Sulaiti G, Emery D. Vertebral artery dissection: warning symptoms, clinical features and prognosis in 26 patients.  Can J Neurol Sci . 2000;  27 292-296
  • 42 Houser O W, Mokri B, Sundt Jr M T. et al . Spontaneous cervical cephalic arterial dissection and its residuum: angiographic spectrum.  AJNR Am J Neuroradiol . 1984;  5 27-34
  • 43 Friedman D P, Flanders A E. Unusual dissection of the proximal vertebral artery: description of three cases.  AJNR Am J Neuroradiol . 1992;  13 283-286
  • 44 Mani R L, Eisenberg R L, McDonald Jr J E. et al . Complications of catheter cerebral arteriography: analysis of 5,000 procedures. I. Criteria and incidence.  AJR Am J Roentgenol . 1978;  131 861-865
  • 45 Mani R L, Eisenberg R L. Complications of catheter cerebral arteriography: analysis of 5,000 procedures. II. Relation of complication rates to clinical and arteriographic diagnoses.  AJR Am J Roentgenol . 1978;  131 867-869
  • 46 Mani R L, Eisenberg R L. Complications of catheter cerebral arteriography: analysis of 5,000 procedures. III. Assessment of arteries injected, contrast medium used, duration of procedure, and age of patient.  AJR Am J Roentgenol . 1978;  131 871-874
  • 47 Dion J E, Gates P C, Fox A J. et al . Clinical events following neuroangiography: a prospective study.  Stroke . 1987;  18 997-1004
  • 48 Warnock N G, Gandhi M R, Bergvall U, Powell T. Complications of intraarterial digital subtraction angiography in patients investigated for cerebral vascular disease.  Br J Radiol . 1993;  66 855-858
  • 49 Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. Endarterectomy for asymptomatic carotid artery stenosis.  JAMA . 1995;  273 1421-1428
  • 50 Sturzenegger M, Mattle H P, Rivoir A, Baumgartner R W. Ultrasound findings in carotid artery dissection: analysis of 43 patients.  Neurology . 1995;  45 691-698
  • 51 Steinke W, Rautenberg W, Schwartz A, Hennrici M. Noninvasive monitoring of internal carotid artery dissection.  Stroke . 1994;  25 998-1005
  • 52 Rommel O, Niedeggen A, Tegenthoff M. et al . Carotid and vertebral artery injury following severe head or cervical spine trauma.  Cerebrovasc Dis . 1999;  9 202-209
  • 53 Srinivasan J, Newell D W, Sturzenegger M. et al . Transcranial Doppler in the evaluation of internal carotid artery dissection.  Stroke . 1996;  27 1226-1230
  • 54 Klufas R A, Hsu L, Barnes P D. et al . Dissection of the carotid and vertebral arteries: imaging with MR angiography.  AJR Am J Roentgenol . 1995;  164 673-677
  • 55 Sue D E, Brant-Zawadzki M N, Chance J. Dissection of cranial arteries in the neck: correlation of MRI and arteriography.  Neuroradiology . 1992;  34 273-278
  • 56 Ofer A, Nitecki S S, Braun J. et al . CT angiography of the carotid arteries in trauma to the neck.  Eur J Vasc Endovasc Surg . 2001;  21 401-407
  • 57 Eachempati S R, Vaslef S N, Sebastian M W, Reed 2nd L R. Blunt vascular injuries of the head and neck: is heparinization necessary?.  J Trauma . 1998;  45 997-1004
  • 58 Coric D, Wilson J A, Regan J D, Bell D A. Primary stenting of the extracranial internal carotid artery in a patient with multiple cervical dissections: technical case report.  Neurosurgery . 1998;  43 956-959
  • 59 DeOcampo J, Brillman J, Levy D I. Stenting: a new approach to carotid dissection.  J Neuroimaging . 1997;  7 187-190
  • 60 Dorros G, Cohn J M, Palmr L E. Stent deployment resolves a petrous carotid artery angioplasty dissection.  AJNR Am J Neuroradiol . 1998;  19 392-394
  • 61 Duke B J, Ryu R K, Coldwell D M, Brega K E. Treatment of blunt injury to the carotid artery by using endovascular stents: an early experience.  J Neurosurg . 1997;  87 825-829
  • 62 Klein G E, Szolar D H, Raith J. et al . Posttraumatic extracranial aneurysm of the internal carotid artery: combined endovascular treatment with coils and stents.  AJNR Am J Neuroradiol . 1997;  18 1261-1264
  • 63 Miyachi S, Ishiguchi T, Taniguchi K. et al . Endovascular stenting of a traumatic dissecting aneurysm of the extracranial internal carotid artery-case report.  Neurol Med Chir . 1997;  37 270-274
  • 64 Price R F, Sellar R, Leung C, O'Sullivan M J. Traumatic vertebral arterial dissection and vertebrobasilar arterial thrombosis successfully treated with endovascular thrombolysis and stenting.  AJNR Am J Neuroradiol . 1998;  19 1677-1680
  • 65 Yamashita K, Okamoto S, Kim C. et al . Emergent treatment of iatrogenic dissection of the internal carotid artery with the Palmaz-Schatz stent-case report.  Neurol Med Chir . 1997;  37 336-339
  • 66 Malek A M, Higashida R T, Phatouros C C. et al . Endovascular management of extracranial carotid artery dissection achieved using stent angioplasty.  AJNR Am J Neuroradiol . 2000;  21 1280-1292