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Delayed Stroke following Blunt Neck Trauma: A Case Illustration with Recommendations for Diagnosis and Treatment

Blunt cerebrovascular injury (BCVI) to the carotid artery is a relatively rare injury that is difficult to identify even with imaging. Any symptoms or neurological deficits following blunt neck injury mandate evaluation and consideration of BCVI. In an effort to highlight this issue, we report the c...

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Autores principales: Anyama, Best, Treitl, Daniela, Wessell, Jeffery, Solomon, Rachele, Rosenthal, Andrew A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5322429/
https://www.ncbi.nlm.nih.gov/pubmed/28280639
http://dx.doi.org/10.1155/2017/3931985
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author Anyama, Best
Treitl, Daniela
Wessell, Jeffery
Solomon, Rachele
Rosenthal, Andrew A.
author_facet Anyama, Best
Treitl, Daniela
Wessell, Jeffery
Solomon, Rachele
Rosenthal, Andrew A.
author_sort Anyama, Best
collection PubMed
description Blunt cerebrovascular injury (BCVI) to the carotid artery is a relatively rare injury that is difficult to identify even with imaging. Any symptoms or neurological deficits following blunt neck injury mandate evaluation and consideration of BCVI. In an effort to highlight this issue, we report the case of a 31-year-old male patient who presented with left-sided weakness consistent with transient ischemic attack (TIA) and concussion. The patient's symptoms occurred within 24 hours of a blunt neck injury sustained by a knee strike during a basketball game. An initial computerized tomography (CT) scan of the brain was normal; a CT angiogram (CTA) of the neck and carotids did not reveal obstruction, dissection, stenosis, or abnormalities of the carotid or vertebral vessels and the patient was subsequently discharged. A magnetic resonance imaging (MRI) of the brain obtained four days after the initial injury demonstrated an acute infarct in the right middle cerebral artery (MCA) territory. Thus, despite initial negative imaging, neurological deficits must be aggressively pursued in order to prevent stroke in BCVI cases.
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spelling pubmed-53224292017-03-09 Delayed Stroke following Blunt Neck Trauma: A Case Illustration with Recommendations for Diagnosis and Treatment Anyama, Best Treitl, Daniela Wessell, Jeffery Solomon, Rachele Rosenthal, Andrew A. Case Rep Emerg Med Case Report Blunt cerebrovascular injury (BCVI) to the carotid artery is a relatively rare injury that is difficult to identify even with imaging. Any symptoms or neurological deficits following blunt neck injury mandate evaluation and consideration of BCVI. In an effort to highlight this issue, we report the case of a 31-year-old male patient who presented with left-sided weakness consistent with transient ischemic attack (TIA) and concussion. The patient's symptoms occurred within 24 hours of a blunt neck injury sustained by a knee strike during a basketball game. An initial computerized tomography (CT) scan of the brain was normal; a CT angiogram (CTA) of the neck and carotids did not reveal obstruction, dissection, stenosis, or abnormalities of the carotid or vertebral vessels and the patient was subsequently discharged. A magnetic resonance imaging (MRI) of the brain obtained four days after the initial injury demonstrated an acute infarct in the right middle cerebral artery (MCA) territory. Thus, despite initial negative imaging, neurological deficits must be aggressively pursued in order to prevent stroke in BCVI cases. Hindawi Publishing Corporation 2017 2017-02-09 /pmc/articles/PMC5322429/ /pubmed/28280639 http://dx.doi.org/10.1155/2017/3931985 Text en Copyright © 2017 Best Anyama et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Anyama, Best
Treitl, Daniela
Wessell, Jeffery
Solomon, Rachele
Rosenthal, Andrew A.
Delayed Stroke following Blunt Neck Trauma: A Case Illustration with Recommendations for Diagnosis and Treatment
title Delayed Stroke following Blunt Neck Trauma: A Case Illustration with Recommendations for Diagnosis and Treatment
title_full Delayed Stroke following Blunt Neck Trauma: A Case Illustration with Recommendations for Diagnosis and Treatment
title_fullStr Delayed Stroke following Blunt Neck Trauma: A Case Illustration with Recommendations for Diagnosis and Treatment
title_full_unstemmed Delayed Stroke following Blunt Neck Trauma: A Case Illustration with Recommendations for Diagnosis and Treatment
title_short Delayed Stroke following Blunt Neck Trauma: A Case Illustration with Recommendations for Diagnosis and Treatment
title_sort delayed stroke following blunt neck trauma: a case illustration with recommendations for diagnosis and treatment
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5322429/
https://www.ncbi.nlm.nih.gov/pubmed/28280639
http://dx.doi.org/10.1155/2017/3931985
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