Neurologic consequences of cerebrovascular injury. J Trauma 1992 Jun;32(6):755-8; discussion 758-60
Date
06/11/1992Pubmed ID
1613835DOI
10.1097/00005373-199206000-00014Scopus ID
2-s2.0-0026751154 (requires institutional sign-in at Scopus site) 21 CitationsAbstract
Because of ongoing controversy, the issue of vascular repair or ligation for patients with cerebrovascular injuries and preoperative central neurologic deficits is frequently debated. A total of 133 patients with penetrating cerebrovascular injuries were analyzed. The frequency of preoperative neurologic deficit was 20% (27 patients). The common carotid and internal carotid arteries were the most frequently injured structures, with a 29% and 15% incidence of preoperative neurologic deficits, respectively. The results of carotid repair in all patients whose preoperative deficit was limited to weakness or paralysis were favorable (seven patients normal or improved, two patients unchanged). The results of repair in patients whose preoperative deficit was characterized by obtundation were variable (four patients improved, four patients worsened or died). The results of carotid ligation were also variable (one improved, one unchanged, three worsened or died). Limited numbers of patients with preoperative neurologic deficits and the retrospective nature of this review prohibit definite conclusions. Therefore a multicenter, prospective, randomized trial of ligation or vascular repair for comatose patients with cerebrovascular injuries is proposed.
Author List
Richardson R, Obeid FN, Richardson JD, Hoyt DB, Wisner DH, Gomez GA, Johansen K, McSwain NE Jr, Weigelt JA, Blaisdell FWMESH terms used to index this publication - Major topics in bold
Carotid Artery InjuriesCerebral Arteries
Cerebrovascular Disorders
Coma
Humans
Incidence
Retrospective Studies
Societies, Medical
Traumatology
Treatment Outcome
United States
Vascular Surgical Procedures
Wounds, Penetrating
