Résumé
Blunt carotid artery injury is uncommon, yet not rare. However, it is often underdiagnosed because of inconsistent early symptoms or masking by the presence of coexisting brain and spinal injuries. The delay between the accident and the onset of cerebral ischemic symptoms is variable and has been reported to range from minutes to ten years. However, to our knowledge, there has been no report on a case presented with delayed intracerebral hemorrhage 25months after blunt carotid artery injury. We report on a case with discussion of supporting evidence and possible mechanisms.
Sujets)
Encéphale , Artères carotides , Lésions traumatiques de l'artère carotide , Hémorragie cérébrale , Masques , Traumatisme du rachisRésumé
The occurrence of delayed intracerebral hemorrhage is more frequent than previously reported and is associated with a poor outcome. Early detection and proper management is important in that aspect. The progression tends to be insidious. When the patient's consciousness gets worse or is not improving within resonable time, the second CT scan should be performed. In a retrospective study of 211 consecutive patients with traumatic intracranial hematomas, we identified 12 cases(5.6%) with delayed traumatic intracerebral hemorrhage(DTICH). Among these, five(41.6%) died of DTICH. Cerebral contusion on initial CT, acceleration-deceleration injury with rotational forces, surgical decompression would be important contributors in the development of DTICH.