RESUMO
Rupture of the internal carotid artery (ICA) during transsphenoidal surgery is a rare but potentially lethal complication. Direct surgical repair of the ICA may be difficult and time-consuming in an acute setting. Urgent endovascular treatments with vascular plug or stent-graft have been the feasible options to date. We desrcibe two cases of iatrogenic rupture of ICA during transsphenoidal surgery. In the first case we occluded the ICA with a vascular plug at the site of tear where cross circulation was adequate. In the second case we had to preserve the ICA with stent-graft since there was no adequate cross circulation. These two strategies are discussed below.
Assuntos
Prótese Vascular , Lesões das Artérias Carótidas/etiologia , Lesões das Artérias Carótidas/cirurgia , Artéria Carótida Interna/cirurgia , Craniotomia/efeitos adversos , Osso Esfenoide/cirurgia , Stents , Procedimentos Cirúrgicos Vasculares/instrumentação , Adulto , Lesões das Artérias Carótidas/diagnóstico por imagem , Artéria Carótida Interna/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Ruptura/diagnóstico por imagem , Ruptura/etiologia , Ruptura/cirurgia , Procedimentos Cirúrgicos Vasculares/métodosRESUMO
Computed tomography scan findings are described in cerebral arterial gas embolism in two patients with right to left intracardiac shunts by accidental injection of air during intravenous therapy. Although imaging may not be necessary to diagnose the condition, the patient may be referred to CT scan as a case of stroke. Cerebral arterial gas embolism should be considered in the differential diagnosis of stroke, particularly in case of right-to-left shunts. CT findings described are classical and diagnostic of the condition.
