Abstract
IntroductionBlunt injury to the carotid and vertebral arteries is uncommon and potentially devastating. Neurofibromatosis type 1, or von Recklinghausen’s disease is an autosomal dominant disorder affecting one in 3000 individuals. This genetic disease may affect many organs, including vessels.Case presentationThis report describes a very unusual case of multiple traumatic arterial injuries in a 44-year-old Caucasian neurofibromatosis type 1 patient, with delayed diagnosis. The vascular abnormalities observed in neurofibromatosis type 1, probably enhanced the arterial lesions. Medical treatment with antiplatelet therapy combined with endovascular stent-assisted angioplasty allowed a good evolution for the patient.ConclusionPatients with medical history of neurofibromatosis type I are at risk to develop blunt cervical vascular injury. This association has to be known by emergency and intensivist physicians to optimize screening of cerebrovascular injuries and treat early such devastating lesions.
Highlights
Blunt injury to the carotid and vertebral arteries is uncommon and potentially devastating
The vascular abnormalities observed in neurofibromatosis type 1, probably enhanced the arterial lesions
Patients with medical history of neurofibromatosis type I are at risk to develop blunt cervical vascular injury
Summary
Among patients admitted to the hospital for blunt trauma, the incidence of carotid artery injury is approximately 1% [1]. The most common vascular abnormality in patients with NF-1 is renal artery stenosis. Except for disorientation, the patient showed no neurologic abnormalities. He complained of chest pain and headache. On day 6, the patient was extubated He complained of a constant bruit synchronized with the arterial pulse that he could hear in his head. A cerebral angiography confirmed a right internal carotid pseudo aneurysm (Figure 2), and revealed a left internal carotid artery dissection (Figure 3) and a right vertebral arterio-venous fistula. On day 8, the right carotid artery underwent balloon angioplasty and stenting. The patient was discharged from the hospital on day 35, without any neurological sequelae
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