Diagnosis and treatment of post-traumatic occlusion of internal carotid artery: A report of three cases

Abstract

Objective To investigate the clinical characteristics, diagnosis and treatment strategies of post-traumatic occlusion of internal carotid artery. Methods The clinical data of 3 patients with post-traumatic occlusion of internal carotid artery were analyzed retrospectively who underwent treatment at neurological intensive care unit of Affiliated Hospital of Logistics University of Chinese People’s Armed Police Forces from April 2016 to March 2017. Results Among the 3 patients with massive cerebral infarction treated successfully, 1 underwent conservative treatment and the other 2 received decompressive craniectomy and internal decompression. Followed up for 5-12 months, the patients showed the GOS (Glasgow outcome scale) score of 4 in 1 case and 3 in 2 cases. Conclusions Post-traumatic occlusion of internal carotid artery is relatively rare and easy to be misdiagnosed, which often results in massive cerebral infarction and its prognosis seems to be very poor. Reasonable application of MRI, MRA, CTA and DSA could be helpful for early diagnosis. The major treatment includes early antiplatelet therapy, endovascular treatment and large decompressive craniectomy. Early diagnosis and treatment are important to its prognosis. Key words: Cerebrovascular trauma; Arterial occlusive diseases; Carotid artery, internal; Trauma; Therapy