Unstable Stenosis of the Internal Carotid Artery Caused by a Craniofacial Nail-Gun Injury : Case Report
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概要
- 論文の詳細を見る
A 30-year-old carpenter suffered accidental piercing of his jaw by a 3-inch nail from a nail gun. No neurological deficits were found on admission. Computed tomography showed that the tip of the nail had reached the foramen lacerum. Cerebral angiography revealed severe stenosis at the C4 portion of the left internal carotid artery (ICA) and marked decrease in the flow of the distal ICA. He had developed right hemiparesis and sensory aphasia by the following morning. T2-weighted and fluid-attenuated inversion recovery magnetic resonance imaging showed a focal hyperintense signal in the left central region indicating cerebral infarction. Repeat angiography demonstrated that the antegrade blood flow from the occluded point on the admission day had partially resumed, and endovascular trapping of the ICA was successfully carried out. The nail was then removed safely without problematic bleeding. The patient suffered no additional deficit, and his sensory aphasia and right hemiparesis gradually improved. The fluctuating blood flow through the unstable stenosis of the ICA related to nail movement possibly caused the delayed cerebral infarction. To avoid the occurrence of such events, rapid treatment after necessary investigations is recommended in patients with craniofacial penetrating injuries that affect the ICA.
- 社団法人 日本脳神経外科学会の論文
- 2009-12-15
著者
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Kobayashi Tsutomu
Department Of Hypertension And Cardiorenal Medicine Dokkyo University School Of Medicine
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Ito Yasushi
Department Of Neurosurgery Brain Research Institute University Of Niigata
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Fujii Yukihiko
Department Of Neurosurgery Brain Research Institute Niigata University
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Kawaguchi Tadashi
Department Of Neurosurgery Nagaoka Red Cross Hospital
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Kawaguchi Tadashi
Department Of Neurosurgery Brain Research Institute Niigata University
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HIRAISHI Tetsuya
Department of Neurosurgery, Brain Research Institute, Niigata University
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Ito Yasushi
Department Of Biological Diversity Faculty Of Agriculture Gifu University
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TOMIKAWA Masaru
Department of Neurosurgery, Nagaoka Red Cross Hospital
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Tomikawa Masaru
Department Of Neurosurgery Nagaoka Red Cross Hospital
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Hiraishi Tetsuya
Department Of Neurosurgery Brain Research Institute Niigata University
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Hiraishi Tetsuya
Department Of Neurosurgery Nagaoka Red Cross Hospital
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Ito Yasushi
Department Of Biofunctional Molecules Gifu Pharmaceutical University
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Kobayashi Tsutomu
Department Of Neurosurgery Nagaoka Red Cross Hospital
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Kobayashi Tsutomu
Department Of Anesthesiology Harbin Medical University
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Kobayashi Tsutomu
Depariment Of Anatomy Faculty Of Medicine Toho University
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ITO Yasushi
Department of Applied Chemisty, Faculty of Technology, Tokyo University of Agriculture and Technology
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