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Progressive hematoma in anterior neck after endovascular treatment of middle cerebral artery aneurysm
BACKGROUND: Cervical hematomas can lead to airway compromise, a life threatening condition, regardless of the cause. The following case is the first presentation of cervical hematoma as a complication of endovascular treatment of middle cerebral artery aneurysm. CASE REPORT: A 49 year-old woman was...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9391691/ https://www.ncbi.nlm.nih.gov/pubmed/28024711 http://dx.doi.org/10.1016/j.bjane.2015.09.004 |
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author | Ankay Yilbas, Aysun Kanburoglu, Cigdem Uzumcugil, Filiz Cifci, Coskun Ozen Saralp, Ozge Karagoz, Heves Akinci, Seda Banu Arat, Anil |
author_facet | Ankay Yilbas, Aysun Kanburoglu, Cigdem Uzumcugil, Filiz Cifci, Coskun Ozen Saralp, Ozge Karagoz, Heves Akinci, Seda Banu Arat, Anil |
author_sort | Ankay Yilbas, Aysun |
collection | PubMed |
description | BACKGROUND: Cervical hematomas can lead to airway compromise, a life threatening condition, regardless of the cause. The following case is the first presentation of cervical hematoma as a complication of endovascular treatment of middle cerebral artery aneurysm. CASE REPORT: A 49 year-old woman was scheduled for stent placement under general anesthesia for middle cerebral artery aneurysm. Few days before intervention, acetyl salicylic acid and clopidogrel treatment was started. Following standard monitoring and anesthesia induction, the patient's trachea was intubated with a 7.5 mm endotracheal tube and the procedure was completed without any complications. Three hours later, dyspnea developed and physical examination revealed progressive swelling and stiffness in the neck. Endotracheal intubation was performed with a 6 mm diameter uncuffed tube with the aid of sedation. The vocal cords were completely closed due to compression. There was no leak around the endotracheal tube. The rapidly performed computerized tomography scans showed an enormous hematoma around the neck and extravasation of contrast medium through superior thyroid artery. After coil embolization of superior thyroid artery, she was taken to the intensive care unit as intubated and sedated. Surgical exploration of the hematoma was not recommended by the surgeons, because she was on clopidogrel. After two days, the patient's trachea was extubated safely ensuring that the swelling was sufficiently ceased and leak detected around the endotracheal tube. CONCLUSIONS: Securing the airway rapidly by endotracheal intubation is the most crucial point in the management of cervical hematomas. Diagnostic and therapeutic procedures should be performed only afterwards. |
format | Online Article Text |
id | pubmed-9391691 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-93916912022-08-21 Progressive hematoma in anterior neck after endovascular treatment of middle cerebral artery aneurysm Ankay Yilbas, Aysun Kanburoglu, Cigdem Uzumcugil, Filiz Cifci, Coskun Ozen Saralp, Ozge Karagoz, Heves Akinci, Seda Banu Arat, Anil Braz J Anesthesiol Clinical Information BACKGROUND: Cervical hematomas can lead to airway compromise, a life threatening condition, regardless of the cause. The following case is the first presentation of cervical hematoma as a complication of endovascular treatment of middle cerebral artery aneurysm. CASE REPORT: A 49 year-old woman was scheduled for stent placement under general anesthesia for middle cerebral artery aneurysm. Few days before intervention, acetyl salicylic acid and clopidogrel treatment was started. Following standard monitoring and anesthesia induction, the patient's trachea was intubated with a 7.5 mm endotracheal tube and the procedure was completed without any complications. Three hours later, dyspnea developed and physical examination revealed progressive swelling and stiffness in the neck. Endotracheal intubation was performed with a 6 mm diameter uncuffed tube with the aid of sedation. The vocal cords were completely closed due to compression. There was no leak around the endotracheal tube. The rapidly performed computerized tomography scans showed an enormous hematoma around the neck and extravasation of contrast medium through superior thyroid artery. After coil embolization of superior thyroid artery, she was taken to the intensive care unit as intubated and sedated. Surgical exploration of the hematoma was not recommended by the surgeons, because she was on clopidogrel. After two days, the patient's trachea was extubated safely ensuring that the swelling was sufficiently ceased and leak detected around the endotracheal tube. CONCLUSIONS: Securing the airway rapidly by endotracheal intubation is the most crucial point in the management of cervical hematomas. Diagnostic and therapeutic procedures should be performed only afterwards. Elsevier 2016-04-13 /pmc/articles/PMC9391691/ /pubmed/28024711 http://dx.doi.org/10.1016/j.bjane.2015.09.004 Text en © 2016 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Clinical Information Ankay Yilbas, Aysun Kanburoglu, Cigdem Uzumcugil, Filiz Cifci, Coskun Ozen Saralp, Ozge Karagoz, Heves Akinci, Seda Banu Arat, Anil Progressive hematoma in anterior neck after endovascular treatment of middle cerebral artery aneurysm |
title | Progressive hematoma in anterior neck after endovascular treatment of middle cerebral artery aneurysm |
title_full | Progressive hematoma in anterior neck after endovascular treatment of middle cerebral artery aneurysm |
title_fullStr | Progressive hematoma in anterior neck after endovascular treatment of middle cerebral artery aneurysm |
title_full_unstemmed | Progressive hematoma in anterior neck after endovascular treatment of middle cerebral artery aneurysm |
title_short | Progressive hematoma in anterior neck after endovascular treatment of middle cerebral artery aneurysm |
title_sort | progressive hematoma in anterior neck after endovascular treatment of middle cerebral artery aneurysm |
topic | Clinical Information |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9391691/ https://www.ncbi.nlm.nih.gov/pubmed/28024711 http://dx.doi.org/10.1016/j.bjane.2015.09.004 |
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