Internal carotid artery traumatic thrombosis

Introduction The common carotid artery is the main artery of the head and neck, and the upper thyroid cartilage branches into the internal carotid artery and the external carotid artery. The incidence of traumatic embolism is higher in the internal carotid artery because the internal carotid artery is mainly brain and visual. Neck contusion can directly squeeze the blunt contusion in the oral cavity of the carotid artery wall and the oropharynx, and can also affect the carotid wall through the tissue around the tonsil. The principle of treatment of traumatic thrombosis of the internal carotid artery is to relieve vasospasm, prevent thrombosis, stop thrombus expansion, and maintain maximum collateral circulation.

Cause

1. Direct injury to the artery: neck contusion can directly squeeze the blunt contusion in the oral cavity of the carotid artery wall and the oropharynx, and can also affect the carotid wall through the tissue around the tonsil.

2. The artery is suddenly pulled: when the contusion is excessively stretched or twisted or the external force shifts the brain tissue, the internal carotid artery with the upper end fixed to the cavernous sinus is suddenly subjected to severe necking of the neck, and the internal carotid artery is also impacted. The arterial wall was contused on the cervical transverse process.

3. Cranial neck trauma and skull base fracture: The internal carotid artery is often contused in the bone canal.

4. Carotid artery atherosclerotic lesions: embolism occurs after atherosclerosis is easy to fall off after contusion.

an examination

Related inspection

Cerebral Doppler Ultrasound (TCD) Carotid Pulmonary Examination Cervical Cervical CT CT Neck Examination

1. Neck hematoma:

After carotid contusion, there may be hematoma formation in the anterior triangle of the neck.

2.Horner syndrome:

Often preceded by other neurological disorders, the upper cervical sympathetic chain and the first cervical ganglion are adjacent to the internal carotid artery.

3. Transient ischemic attack:

The mechanism of cerebral ischemic attack occurs in carotid atherosclerotic stenosis and thrombosis.

4. There is an intermediate waking period:

There is a clear interval between the injury and the occurrence of severe neurological symptoms. This is a characteristic of carotid contusion. It takes a process time to count the neurological lesions from thrombosis to complete obstruction of the arterial lumen after vascular contusion. Hours to 2 weeks, averaged 24h

5. Limb paralysis or hemiplegia:

Because of vasospasm or thrombosis, the cerebral ischemic softening often occurs as a single sputum or hemiplegia, but the patient is clear-minded.

6. The facial artery or superficial temporal artery pulsation disappears:

For example, the common carotid artery or external carotid artery has embolized the palpation of the facial artery or the superficial temporal artery and its pulsation disappears.

Differential diagnosis

Need to be identified with the following symptoms:

Arterial stealing blood: Carotid steal syndrome refers to the internal carotid artery occlusion, the blood flow of the internal carotid artery flows through the anterior communicating artery into the affected side, and the blood flow of the internal carotid artery flows through the anterior communicating artery into the affected side. The onset of the internal carotid artery ischemic manifestation, or the vertebral-basal artery blood flow can flow back into the affected internal carotid artery through the posterior communicating artery, resulting in vertebral-basal artery ischemic manifestations, such as bilateral internal carotid artery occlusion. The blood supply by the vertebrobasilar artery and the external carotid artery can be accompanied by damage to the brain and cerebellum. The cause is mostly the formation of atherosclerotic plates. Clinical manifestations of recurrent intracranial arterial system transient cerebral arterial insufficiency, such as transient side of the lesion side of the black, lesions of the opposite side of the limb numbness, hemiparesis, aphasia and so on. Internal carotid artery stenosis >75%, audible vascular murmur, weakened or small internal carotid artery pulse. When the ischemic symptoms appear in a blood supply area of a blood vessel and the DSA is normal, the possibility of cerebral artery reflux or steal syndrome may be considered.

Carotid plaque: Carotid plaque is carotid atherosclerosis, and each coronary artery is the same as atherosclerosis.

Carotid sinus syncope: Carotid sinus syncope, also known as carotid sinus syndrome, is a group of spontaneous clinical symptoms of sudden dizziness, fatigue, tinnitus and even syncope.

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