Delayed evaluation of combat-related penetrating neck trauma

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Without prejudice Journal of Vascular Surgery

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Presentation transcript:

Delayed evaluation of combat-related penetrating neck trauma Charles J. Fox, MD, David L. Gillespie, MD, Michael A. Weber, MD, Mitchell W. Cox, MD, Jason S. Hawksworth, MD, Chad M. Cryer, MD, Norman M. Rich, MD, Sean D. O’Donnell, MD Journal of Vascular Surgery Volume 44, Issue 1, Pages 86-93 (July 2006) DOI: 10.1016/j.jvs.2006.02.058 Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 1 A, The quality of computed tomography angiography can be easily degraded by metallic artifact (arrow) (B) as depicted by subsequent sections acquired within the zone of injury. C, A carotid pseudoaneurysm (arrow) was later discovered on the arteriogram. Journal of Vascular Surgery 2006 44, 86-93DOI: (10.1016/j.jvs.2006.02.058) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 2 A, The lingual artery pseudoaneurysm (arrow) is demonstrated on the initial computed tomography angiography. B, The subsequent arteriogram shows the pseudoaneurysm (arrow). C, Arteriogram illustrates the utility of endovascular coiling to manage an occult injury in a difficult location. Journal of Vascular Surgery 2006 44, 86-93DOI: (10.1016/j.jvs.2006.02.058) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 3 Plain radiographs demonstrate that metallic deposits by explosive munitions (long white arrows) or high velocity weapons (short black arrow) can predict the potential inaccuracy of a computed tomography angiography. Journal of Vascular Surgery 2006 44, 86-93DOI: (10.1016/j.jvs.2006.02.058) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 4 Contrast arteriography is recommended when metallic fragments are in the zone of injury, as illustrated by this combined internal carotid and vertebral artery injury from a cervical gunshot wound. Journal of Vascular Surgery 2006 44, 86-93DOI: (10.1016/j.jvs.2006.02.058) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions