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Imaging characteristics and treatment strategies for carotid artery occlusion caused by skull base fracture:Three case reports 被引量:1
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作者 Pei-Xin Shangguan Ke-Chun Zhou 《World Journal of Clinical Cases》 SCIE 2024年第15期2664-2671,共8页
BACKGROUND Traumatic internal carotid artery(ICA)occlusion is a rare complication of skull base fractures,characterized by high mortality and disability rates,and poor prognosis.Therefore,timely discovery and correct ... BACKGROUND Traumatic internal carotid artery(ICA)occlusion is a rare complication of skull base fractures,characterized by high mortality and disability rates,and poor prognosis.Therefore,timely discovery and correct management are crucial for saving the lives of such patients and improving their prognosis.This article retrospectively analyzed the imaging and clinical data of three patients,to explore the imaging characteristics and treatment strategies for carotid artery occlusion,combined with severe skull base fractures.CASE SUMMARY This case included three patients,all male,aged 21,63,and 16 years.They underwent plain film skull computed tomography(CT)examination at the onset of their illnesses,which revealed fractures at the bases of their skulls.Ultimately,these cases were definitively diagnosed through CT angiography(CTA)examinations.The first patient did not receive surgical treatment,only anticoagulation therapy,and recovered smoothly with no residual limb dysfunction(Case 1).The other two patients both developed intracranial hypertension and underwent decompressive craniectomy.One of these patients had high intracranial pressure and significant brain swelling postoperatively,leading the family to choose to take him home(Case 2).The other patient also underwent decompressive craniectomy and recovered well postoperatively with only mild limb motor dysfunction(Case 3).We retrieved literature from PubMed on skull base fractures causing ICA occlusion to determine the imaging characteristics and treatment strategies for this type of disease.CONCLUSION For patients with cranial trauma combined with skull base fractures,it is essential to complete a CTA examination as soon as possible,to screen for blunt cerebrovascular injury. 展开更多
关键词 Skull base fracture Traumatic internal carotid artery occlusion blunt cerebrovascular injury Imaging Case report
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Imaging characteristics and treatment strategies for carotid artery occlusion caused by skull base fracture
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作者 Xue-Jian Wang 《World Journal of Clinical Cases》 SCIE 2024年第31期6513-6516,共4页
The internal carotid artery occlusion caused by head and neck trauma,also known as traumatic intracranial artery occlusion,is relatively rare clinically.Traumatic skull base fracture is a common complication of trauma... The internal carotid artery occlusion caused by head and neck trauma,also known as traumatic intracranial artery occlusion,is relatively rare clinically.Traumatic skull base fracture is a common complication of traumatic brain injury.Traumatic skull base fracture is one of the causes of traumatic internal carotid artery occlusion.If not detected early and treated in time,the prognosis of patients is poor.This editorial makes a relevant analysis of this disease. 展开更多
关键词 Skull base fracture Traumatic internal carotid artery occlusion blunt cerebrovascular injury IMAGING Imaging characteristics Treatment strategies
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外伤性脑损伤患者发生钝性脑血管损伤的危险因素及早期抗凝的研究 被引量:3
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作者 吴娅秋 黄光富 《中国急救医学》 CAS CSCD 北大核心 2018年第1期71-75,共5页
目的评价并发钝性血管损伤(BCVI)的重度外伤性脑损伤(TBI)患者的疾病特征以及发生BCVI的危险因素与早期抗凝治疗的影响。方法选取2010-07-2016-06在四川省医学科学院四川省人民医院神经外科ICU治疗的TBI患者。根据患者是否发生BCVI... 目的评价并发钝性血管损伤(BCVI)的重度外伤性脑损伤(TBI)患者的疾病特征以及发生BCVI的危险因素与早期抗凝治疗的影响。方法选取2010-07-2016-06在四川省医学科学院四川省人民医院神经外科ICU治疗的TBI患者。根据患者是否发生BCVI,将患者分为BCVI组与非BCVI组。单因素分析两组患者临床变量、BCVl分级、术后6个月和1年预后差异,采用多因素Logistic回归模型分析患者发生BCVI的危险因素,分析BCVI患者的治疗过程及并发症发病情况。结果共纳入505例重症TBI患者,包括52例(10.3%)BCVI患者与453例非BCVI患者,多因素Logistic回归分析显示,重症TBI患者发生BCVI的危险因素为:ISS评分(OR=2.030,95%C11.146-3.598。P=0.021),摩托车碰撞(OR=2.448,95%C11.336~34.387,P=0.004),累及颈动脉骨折(OR=11.633,95%CI1.250~83.965,P=0.009),颈椎损伤(OR=13.591,95%CI3.498—54.879,P=0.001),肺挫伤(OR=7.941,95%CI1.090~53.432,P=0.031),肝损伤(OR=13.657,95%CI2.765~80.379,P=0.007)。在46例幸存者中,有38例(82.6%)患者进行了全身抗凝治疗,全身抗凝开始时间为人院后第(1.52±0.46)天。结论重症TBI患者发生BCVI比较常见,引发重症TBI患者发生BCVI的主要危险因素是患者发生上躯体损伤(累及颈动脉骨折、颈椎损伤、肺挫伤与肝损伤)和摩托车碰撞损伤,对患者进行早期抗凝治疗是安全有效的。 展开更多
关键词 外伤性脑损伤(TBI) 重症 重症监护病房(ICU) 钝性血管损伤 抗凝治疗
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钝性脑血管损伤的筛查及诊疗进展综述
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作者 周学辉 李津健 +2 位作者 郭洪彬 李新伟 王义荣 《临床医学进展》 2020年第11期2667-2763,共7页
钝性脑血管损伤(Blunt Cerebrovascular Injury, BCVI)包括钝性颈动脉和钝性椎动脉损伤,是一种相对少见但可能产生灾难性后果的损伤。由于钝性脑血管损伤的临床表现多样,且损伤往往合并有多脏器系统损伤,临床医生往往难以初步识别。随... 钝性脑血管损伤(Blunt Cerebrovascular Injury, BCVI)包括钝性颈动脉和钝性椎动脉损伤,是一种相对少见但可能产生灾难性后果的损伤。由于钝性脑血管损伤的临床表现多样,且损伤往往合并有多脏器系统损伤,临床医生往往难以初步识别。随着筛查方法以及CT血管造影(CTA)等检查工具的使用,钝性脑血管损伤的发病率和死亡率都在增高。钝性脑血管损伤的许多方面仍然存在争议,包括筛选标准、诊断方法以及不同类型损伤的最佳治疗方案。本文将从BCVI发病机制、筛查、诊断和治疗等方面进行综述。 展开更多
关键词 钝性脑血管损伤 卒中 脑梗塞 外伤
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创伤性脑血管损伤的识别和治疗
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作者 李建 张立 +4 位作者 高嵘 倪海波 宋照明 陈周青 王中 《中华脑血管病杂志(电子版)》 2023年第6期596-603,共8页
目的探讨创伤性脑血管损伤(TCVI)的危险因素、临床表现及救治方法。方法回顾性分析2012年1月至2022年12月苏州大学附属张家港医院收治的39例TCVI患者的临床资料,统计其临床表现及治疗方法。结果创伤性脑动脉狭窄或闭塞19例患者中,12例... 目的探讨创伤性脑血管损伤(TCVI)的危险因素、临床表现及救治方法。方法回顾性分析2012年1月至2022年12月苏州大学附属张家港医院收治的39例TCVI患者的临床资料,统计其临床表现及治疗方法。结果创伤性脑动脉狭窄或闭塞19例患者中,12例予以抗栓治疗,8例血管管腔完全恢复正常,4例未再通,7例予以支架植入开通血管,死亡1例;创伤性脑动脉瘤8例患者,均行手术治疗,死亡2例;创伤性颈内动脉海绵窦瘘9例患者,均行手术治疗,术后相关症状消失,均恢复良好;脑动脉横断3例患者中,行手术治疗后死亡1例,2例恢复良好。结论对于头颅CT无法解释的神经系统症状、格拉斯哥昏迷评分3~8分、局限性或弥漫性较厚的蛛网膜下腔出血、口鼻腔或外耳道大量出血、颈椎C1~3骨折、颈椎骨折半脱位、穿透性损伤、损伤后出现新的神经系统症状或体征的外伤患者要高度警惕TCVI的存在,可行头颈部CT血管成像或数字减影血管造影明确,针对不同类型的TCVI患者采取个体化治疗方案,有助于改善患者神经功能及预后。 展开更多
关键词 颅脑损伤 穿透性脑血管损伤 钝性脑血管损伤 创伤性颅内动脉瘤
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