1/108. thyroid gland hematoma after blunt cervical trauma.Thyroid hematoma is a rare cause of airway obstruction in victims of blunt trauma. The case of a 34-year-old woman who developed orthopnea after a low-energy motor vehicle accident is described. Presenting greater than 24 hours after her accident, the patient noted dysphagia, tracheal deviation, and postural dyspnea. The diagnosis of thyroid gland hematoma was made with a combination of fiberoptic laryngoscopy, cervical computed tomography, and great vessel and carotid angiography. Invasive airway management was not required. The patient underwent a total thyroidectomy and recovered without complications.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/108. Injury of the vertebral artery after closed head trauma.Two case reports characterized by the complete occlusion of the basilar artery, secondary to dissection of the vertebral artery after closed head trauma are described. These lesions, often clinically silent in the beginning, were able to cause severe neurologic impairment, even after minor head trauma in healthy individuals without predisposing structural disorders. Early detection, based upon the knowledge of the modality of the trauma and upon a correct diagnostic approach, is mandatory to reduce secondary injury. The authors suggest an extensive use of cerebral angiography or angio-magnetic resonance in all cases where clinical conditions are more severe than the computed tomography scan, particularly if the trauma produced a cervical injury with a movement of flexo-extension of the neck. Therapeutic management is discussed. Anti-coagulants, thrombolytic agents or surgical ligation of the vessel has been proposed to prevent the extension of the lesion and to improve the outcome.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/108. Retinal opacification after blunt non-perforating concussional injuries to the globe. A clinical and retinal fluorescein angiographic study.Fluorescein angiographic studies are reported on fifteen patients presenting with retinal opacification after blunt mechanical non-perforating injuries involving the eye. In patients who subsequently regained full visual function and in whom complete resolution of the retinal changes occurred, retinal fluorography carried out less than 24 hours after injury revealed no abnormal features. In cases with more prolonged visual disability, retinal fluorescein examinations may, however, reveal damage to the retinal pigment epithelium before this becomes apparent on routine ophthalmoscopy, or the existence of impaired perfusion through the retinal vessels. It is suggested, therefore, that retinal fluorescein angiography has a role in assessing the visual prognosis in patients presenting with traumatic retinal oedema.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/108. The relationship of blunt head trauma, subarachnoid hemorrhage, and rupture of pre-existing intracranial saccular aneurysms.patients with a history of closed head trauma and subarachnoid hemorrhage are uncommonly diagnosed with an intracranial saccular aneurysm. This study presents a group of patients in whom a pre-existing aneurysm was discovered during work-up for traumatic subarachnoid hemorrhage. Without an accurate pre-trauma clinical history, it is difficult to define the relationship between trauma and the rupture of a pre-existing intracranial saccular aneurysm. We retrospectively reviewed 130 patients who presented to Detroit Receiving Hospital between 1993 and 1997 with a diagnosis of subarachnoid hemorrhage (SAH). Of these 130 patients, 70 were spontaneous, and 60 had a history of trauma. Mechanisms of trauma include motor vehicle accident, assault, or fall from a height. Of the 60 patients with subarachnoid hemorrhage and a history of trauma, 51 (86%) did not undergo conventional four-vessel angiography, and had no further neurological sequelae. Nine patients (14%) had a suspicious quantity of blood within the basal cisterns or Sylvian fissure and had a four-vessel angiogram. Five patients (8%) were diagnosed with a saccular intracranial aneurysm, and all underwent surgical clipping of the aneurysm. We conclude that the majority of patients (92%), with post-traumatic SAH do not harbor intracranial aneurysms. However, during initial evaluation, a high level of suspicion must be entertained when post-traumatic subarachnoid hemorrhage is encountered in the basal cisterns or Sylvian fissure, as 8% of our population were diagnosed with aneurysms.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
5/108. Isolated mesenteric injury due to blunt abdominal trauma.Isolated injuries of the small bowel mesentery or mesocolon with subsequent bowel infarction due to blunt abdominal trauma are rare. Two cases are described: 1 involving the mesentery to the terminal ileum and 1 involving the transverse mesocolon and middle colic artery, both with bowel infarction. The modes of clinical presentation and management of patients with injuries to the mesentery, mesocolon and mesenteric vessels following blunt trauma are described.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/108. indocyanine green angiographic findings in 3 patients with traumatic hypotony maculopathy.PURPOSE: Little is known about the choroidal circulation in human eyes with ocular hypotony. Recently, indocyanine green angiography (IA) became a useful method for examining choroidal circulation. The present study using IA was designed to determine choroidal circulatory disturbances in patients with traumatic hypotony maculopathy. methods: indocyanine green angiography was performed on 3 consecutive patients (3 eyes) with traumatic hypotony. One patient underwent IA using an infrared fundus camera only during the hypotony stage. The other 2 patients underwent IA using a scanning laser ophthalmoscope before and after recovery of intraocular pressure (IOP). RESULTS: During the hypotony stage, IA revealed multiple hypofluorescent spots in many parts of the fundus, sector hypofluorescent areas, dilatation, and tortuosity of the choroidal vessels in the posterior pole. These findings had not been detected by fluorescein angiography. After surgical treatment, IOP returned to the normal range and visual acuity improved. indocyanine green angiography showed improvement of the sector hypofluorescent areas, and dilatation and tortuosity of choroidal vessels in the posterior pole. However, most of the hypofluorescent spots and regional delay of choroidal filling remained. CONCLUSIONS: indocyanine green angiography revealed that choroidal circulatory disturbances occurred during the hypotony stage and that some remained during the recovery stage.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
7/108. Repair of pulmonary vein rupture after deceleration injury.Injuries to the major pulmonary vessels are uncommon and are extremely difficult to manage. We report a case of an isolated pulmonary vein injury following a road traffic accident that was repaired successfully.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/108. Combined brachial plexus and vascular injury in the absence of bony injury.Neurovascular injury to the axillary vessels is well described in association with fracture or dislocation involving the shoulder joint or the humerus. Such injury however can also occur in the absence of bony injury. A case is presented of damage to the axillary artery and brachial plexus following blunt trauma. This case demonstrates that complex neurovascular damage can occur in the absence of fracture or dislocation. The importance of a thorough clinical assessment is highlighted and priorities with regard to diagnosis and management are discussed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/108. Cardiac and great vessel injuries in children after blunt trauma: an institutional review.PURPOSE: The purpose of this study was to review the incidence of cardiac and great vessel injury after blunt trauma in children. METHOD: A retrospective review of 2,744 patients with injuries from blunt mechanisms was performed. RESULTS: Eleven patients sustained cardiac injury. Four patients had clinically evident cardiac contusions. All recovered. Four patients who died from central nervous system injury were found to have cardiac contusions at autopsy. None had clinical evidence of contusion before demise. One patient had a traumatic ventricular septal defect (VSD) that required operative repair. autopsy findings showed a VSD in another patient, and a third patient was found to have a ventricular septal aneurysm that was treated medically. Two patients had great vessel injuries. One patient had a contained disruption of the superior vena cava that was managed nonoperatively. Another patient had a midthoracic periaortic hematoma without intimal disruption found at autopsy. One patient had cardiac and great vessel injuries. Discrete aneurysms of 2 coronary artery branches and the pulmonary outflow tract were identified by cardiac catheterization. This patient was treated nonoperatively. CONCLUSIONS: Cardiac and great vessel injury after blunt trauma are uncommon in children. Cardiac contusion was the most common injury encountered but had minimal clinical significance. Noncontusion cardiac injury is rare. No patient with aortic transection was identified.- - - - - - - - - - ranking = 8keywords = vessel (Clic here for more details about this article) |
10/108. The posterior interosseous flap: a review of 81 clinical cases and 100 anatomical dissections--assessment of its indications in reconstruction of hand defects.Based on our experience of 100 cadaveric dissections and a series of 81 clinical cases, we have assessed the indications for the posterior interosseous flap in reconstruction of the hand. Large fasciocutaneous island flaps can be harvested, even when the radial or ulnar pedicles are damaged, sacrificing only vessels of secondary importance to the perfusion of the hand. Compound flaps can be dissected based on muscular, musculoperiosteal and fascioperiosteal branches. The primary indications for using this flap are dorsal hand defects up to the metacarpal joints, reconstruction of the first web space up to the interphalangeal joint of the thumb and extensive lesions on the ulnar border of the hand.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
| | Next -> |