RESUMO
The diagnosis and surgical management of non-penetrating high cervical internal carotid injuries continues to be a major problem. The increased incidence of these lesions is due to the escalation of motor vehicular trauma involving multi-system injuries as seen in our Trauma Unit. Carotid angiographic studies are necessary for diagnosis when there is an index of suspicion at time of injury. There have been varied opinions concerning the best treatment due to the difficulty of direct access to the para-mandibular, para-antantoxial segment of the internal carotid artery. Two cases of post-traumatic aneurysms have been discussed and an innovative surgical technique is demonstrated with excellent results. This technique can be utilized in other lesions of the high carotid artery such as intimal flaw and/or dissection of this vessel. The primary indications for surgical intervention are propagation of emboli originating in the aneurysmal sac and intolerance of head noise to the patients (not seen in our patients).
Assuntos
Aneurisma/cirurgia , Doenças das Artérias Carótidas/cirurgia , Lesões das Artérias Carótidas , Ferimentos não Penetrantes/complicações , Adolescente , Adulto , Aneurisma/diagnóstico por imagem , Aneurisma/etiologia , Angiografia , Doenças das Artérias Carótidas/diagnóstico por imagem , Doenças das Artérias Carótidas/etiologia , Artéria Carótida Interna/cirurgia , Humanos , Masculino , MétodosRESUMO
Blunt trauma to the chest may produce a spectrum of cardiac lesions extending from asymptomatic myocardial contusion to rapidly fatal cardiac rupture. A case is discussed in which a patient with signs of cardiac tamponade after blunt trauma was found to have a rupture of the atrium. During repair of the cardiac injury, an unusual tear of the right superior pulmonary vein was also discovered. Both injuries were successfully repaired and the patient recovered.
