“No zone” approach in penetrating neck trauma reduces unnecessary computed tomography angiography and negative explorations

2018 ◽  
Vol 221 ◽  
pp. 113-120 ◽  
Author(s):  
Kareem Ibraheem ◽  
Muhammad Khan ◽  
Peter Rhee ◽  
Asad Azim ◽  
Terence O'Keeffe ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Neck Trauma ◽  
Penetrating Neck Trauma ◽  
No Zone Approach

Computed Tomography Angiography in the “No Zone” Approach Era for Penetrating Neck Trauma

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Kareem Ibraheem ◽  
Sunnie Wong ◽  
Alison Smith ◽  
Chrissy Guidry ◽  
Patrick McGrew ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Neck Trauma ◽  
Penetrating Neck Trauma ◽  
No Zone Approach

Role of computed tomography angiography in the management of Zone II penetrating neck trauma in patients with clinical hard signs

2015 ◽  
Vol 79 (6) ◽  
pp. 943-950 ◽  
Author(s):  
Rebecca Schroll ◽  
Tatyana Fontenot ◽  
Megan Lipcsey ◽  
Jiselle Bock Heaney ◽  
Alan Marr ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Neck Trauma ◽  
Penetrating Neck Trauma ◽  
Zone Ii

scholarly journals A retrospective study of computed tomography angiography versus digital subtraction angiography in penetrating neck trauma at Groote Schuur Hospital, South Africa

2014 ◽  
Vol 18 (1) ◽  
Author(s):  
Paul Scholtz ◽  
Steve Beningfield ◽  
Sally Candy
Keyword(s):  
Computed Tomography ◽  
Digital Subtraction Angiography ◽  
Computed Tomography Angiography ◽  
Arterial Injury ◽  
Digital Subtraction ◽  
Neck Trauma ◽  
Imaging Protocol ◽  
Visceral Injury ◽  
Mortality And Morbidity ◽  
Penetrating Neck Trauma

Background: Penetrating neck trauma is commonly encountered in South African trauma units, and is associated with high mortality and morbidity rates. The imaging protocol for stable patients with penetrating neck trauma remains controversial. There is only sparse data validating the use of computed tomography angiography (CTA) in the evaluation of penetrating neck trauma in South Africa.Objectives: To assess the sensitivity and specificity of CTA versus digital subtraction angiography (DSA) in detecting arterial injury and secondarily evaluate the ability of CT to assess non-arterial injury.Method: Using hospital and radiology databases, 23 patients were identified who had undergone both CTA and DSA for penetrating neck trauma. The data was retrospectively anonymised and randomised. A radiologist experienced in the interpretation of both trauma CTA and DSA re-reported all the imaging and the findings were compared and analysed.Results: Twenty-four arterial injuries were detected. The sensitivity of CTA for detecting arterial injury was 78% and the specificity 83%. The ability of CTA to delineate wound track and detect non-arterial visceral injury was also confirmed.Conclusion: CTA is an attractive initial diagnostic investigation that, along with clinical evaluation, effectively guides further investigation and intervention. It is important for the radiologist to understand the limitations of CTA and have a low threshold for DSA in equivocal cases.

Life-threatening carotid haemorrhage following blunt trauma

2009 ◽  
Vol 124 (9) ◽  
pp. 1030-1032
Author(s):  
A Kumar ◽  
J Ahmed ◽  
N Reading ◽  
S Patil ◽  
S Jayaraj
Keyword(s):  
Computed Tomography ◽  
Carotid Artery ◽  
Computed Tomography Angiography ◽  
Internal Carotid ◽  
High Index ◽  
Neck Trauma ◽  
Vessel Injury ◽  
Blunt Neck Trauma ◽  
High Index Of Suspicion ◽  
Carotid Vessel

AbstractIntroduction:We report a case of internal carotid arterial damage following blunt neck trauma. This rare mechanism of injury demands a high index of suspicion to enable prompt specialist management.Case report:A 22-year-old man presented to hospital after sustaining blunt neck trauma. Rapid onset of stridor necessitated an emergency tracheostomy. Computed tomography angiography demonstrated a tear of the right internal carotid artery, which was repaired surgically.Discussion:Blunt carotid vessel injury, although rare, has a high mortality rate. Mechanisms of injury include hyperextension and contralateral neck rotation, a direct blow to the vessel, and laceration by adjacent bony structures. The ‘gold standard’ investigation for suspected blunt carotid vessel injury is catheter angiography, although this carries a small risk of stroke. Computed tomography angiography is a less invasive, alternative investigation which has almost equivalent accuracy. The extent of damage to the vessel wall will dictate treatment. In our literature review, we discuss the presentation, investigation and different treatment modalities available.Conclusion:This case highlights an unusual mechanism of carotid artery injury, with a delayed, potentially fatal presentation. Such injury demands a high index of suspicion, and confirmation with specific investigations. Management is hazardous and requires experienced personnel in all aspects of care.

Mid-aortic syndrome: computed tomography angiography depicting extensive collateral circulation in an 11-year-old patient with thoracoabdominal aortic coarctation

VASA ◽  
2012 ◽  
Vol 41 (2) ◽  
pp. 132-135 ◽  
Author(s):  
Krohn ◽  
Gebauer ◽  
Hübler ◽  
Beck
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Collateral Circulation ◽  
Intestinal Ischemia ◽  
Clinical Presentation ◽  
Lower Limbs ◽  
Upper Body ◽  
Descending Aorta ◽  
Before And After ◽  
Blood Pressures

The mid-aortic syndrome is an uncommon clinical condition characterized by severe narrowing of the descending aorta, usually with involvement of its renal and visceral branches, presenting with uncontrollably elevated blood pressures of the upper body, renal and cardiac failure, intestinal ischemia, encephalopathy symptoms and claudication of the lower limbs, although clinical presentation is variable. In this article we report the case of an eleven-year-old patient with the initial diagnosis of a mid-aortic syndrome and present the computed tomography angiography pictures and reconstructions before and after surgical therapy.

Computed Tomography Angiography (CTA) Evaluation of Spontaneous Subarachnoid Hemorrhage

2020 ◽  
Vol 6 (2) ◽  
pp. 78-81
Author(s):  
Md Tauhidul Islam Chowdhury ◽  
Mohammad Shah Jahirul Hoque Chowdhury ◽  
Mohammad Sadekur Rahman Sarkar ◽  
KM Ahasan Ahmed ◽  
Md Nazmul Kabir ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Computed Tomography Angiography ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Multiple Aneurysm ◽  
Traumatic Subarachnoid Hemorrhage ◽  
One Year ◽  
Spontaneous Subarachnoid Hemorrhage

Background: In evaluation of non-traumatic subarachnoid hemorrhage CT angiography (CTA) has 97-98% sensitivity and near 100% specificity. Objective: This study was conducted to evaluate the CTA findings of CT positive non traumatic subarachnoid hemorrhage. Methodology: This is an observational cross sectional study performed in Neurology department of National Institute of Neurosciences and Hospital, Dhaka over one year period (January 2019 to December 2019). Total 87 CT positive subarachnoid hemorrhage cases were purposively included in this study. All CT positive patients underwent CTA of Cerebral vessels for further evaluation. The angiography were evaluated by competent neuro-radiologists blinded about the study. Result: Among 87 patients, 40.2% were male and 59.8% were female. The average age was 53.33±11.1 years. Among the studied patient the source of bleeding was found 78.16% aneurysmal and 21.84% non-aneurysmal. 85.30% patients had single aneurysm and 14.70% had multiple aneurysm. The highest number of patient had Acom aneurysm (41.17%) followed by MCA (22.05%), ICA (13.23%), ACA (7.35%) and vertebral artery (1.14%) in order of frequency. Among the multiple aneurysm group most of the patients had combination of Acom, MCA and ICA aneurysm. Conclusion: From this study, we can conclude that CTA can be used as the primary diagnostic tool in evaluation of spontaneous SAH. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 78-81

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