Posttraumatic Carotid Cavernous Fistula
| Autor: | R F Phlegar, T S Fabian, David L. Ciraulo, E D Lett, J D Woody, Donald E. Barker, R P Burns |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Adult
Carotid Artery Diseases Intracranial Arteriovenous Malformations Male Chemosis medicine.medical_specialty Adolescent Exophthalmos medicine.medical_treatment Head trauma Disability Evaluation Trauma Centers Basilar skull fracture medicine Craniocerebral Trauma Humans Sign/symptom Embolization Carotid-cavernous fistula Aged Retrospective Studies business.industry Trauma center Middle Aged medicine.disease Embolization Therapeutic Cerebral Angiography Surgery Treatment Outcome Arteriovenous Fistula Female medicine.symptom Tomography X-Ray Computed business |
| Zdroj: | The Journal of Trauma: Injury, Infection, and Critical Care. 47:275-281 |
| ISSN: | 1079-6061 |
| DOI: | 10.1097/00005373-199908000-00009 |
| Popis: | Objective: To increase awareness and understanding of post-traumatic carotid cavernous fistula (PTCCF) with the intent to expedite diagnosis and treatment of this disabling injury, a 14-year retrospective review of patients with angiographically identified PTCCF was conducted at this Level I trauma center. A frequency analysis of signs, symptoms, and disability was performed. The impact on disability of demographics, number of embolization attempts required for closure of the PTCCF, and time from injury to diagnosis was assessed by t test for independent samples. Results: Nine patients were diagnosed with 10 PTCCFs. Mean patient age was 41.5 years. All patients with PTCCF had basilar skull fracture, loss of consciousness, bruit, and chemosis; 90% had exophthalmos; 70% had visual changes; 50% complained of headache; and 80% had some lasting disability. Mean age of patients with partial to total disability was 47 years, while the mean age of patients without lasting disability was 19.5 years (p = 0.013). No statistical correlation could be found between disability and sex, blunt versus penetrating injury, days to diagnosis, or number of embolization attempts. Conclusion: Patients sustaining head trauma with basilar skull fractures and presenting with the described signs and symptoms should be evaluated for PTCCF. Risk of disability does not appear to be influenced by number of attempts at embolization or time to diagnosis. However, age may have a significant impact on outcome. |
| Databáze: | OpenAIRE |
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