5.1 P) Iv) Surgical Trauma Neck Trauma Vascular Injury

Front 1

Which of the following is incorrect regarding blunt trauma to the neck and vascular injury?
1. Carotid artery dissection may follow even trivial neck trauma.
2. Blunt cervical vascular injuries are rare.
3. The most common mechanism for blunt internal carotid artery injury is a sudden , forceful, hyperflexion, medial rotation of the neck.
4. intraoral trauma, particularly in children, can cause internal carotid artery injury.

Back 1

3. sudden , forceful hyperextension and lateral rotation of the neck

Front 2

List the causes of blunt carotid artery injuries?

Back 2

1. MVA ** -seatbelt injuries
2. Fights
3. Athletic events
4. clothesline injuries
5. Near hangings.

Front 3

Blunt vascular injury should be suspected in patients with what injuries?

Back 3

1. Flexion-extension mechanisms
2. neck seat belt sign
3. fractures
a. basilar skull
b. midface
c. mandibular
4. Diffuse axonal brain injury.

Front 4

What type of arterial injuries can occur with blunt neck trauma?

Back 4

1. Intimal tears
2. Thrombosis [and embolisation}
3. Dissection
4. Pseudoaneurysm

Front 5

List the signs and symptoms of vascular injury from blunt trauma to the neck?

Back 5

1. Pulsatile haematoma
2. Bruits
3. Pulse deficit
4. Airway compromise
5. Haemothorax
6. Shock
7. Neurologic deficits **

Front 6

Criteria for screening for cerebrovascular injuries in blunt trauma? { 6}

Back 6

1. Seatbelt mark signs
2. Any bruising / haematoma to neck after trauma
3. Unexplained Neurological deficit
4. Severe maxillofacial injuries
5. Cervical spine fractures with subluxation [especially if transverse foramina are involved]
6. Skull fracture of base of skull [with carotid canal involvement]

Front 7

Most common site for blunt carotid artery trauma?

Back 7

proximal internal carotid artery near bifurcation

Front 8

Range in Clinical picture of blunt vascular injury?

Back 8

Asymptomatic seatbelt mark --> neck haematoma --> hemiparesis / hemiplegia --> coma

Front 9

Best screening tool for blunt vascular injury of neck?

Back 9

Multislice CT Angiography {CTA}

Front 10

Which is incorrect regarding vascular injury post blunt trauma to the neck?
1. Most cases of blunt carotid artery trauma are managed with anticoagulation.
2. Thrombosis and stroke is a risk of delayed diagnosis of blunt vascular injury to the carotid vessels.
3. Blunt vertebral artery trauma is managed with antiplatelet therapy.
4. The most common site of blunt carotid artery trauma is the internal carotid at the level of C2.

Back 10

4. Most common site is is the proximal internal carotid, near the bifurcation.

The second most common is at the level of C2- where the vessel stretches over the transverse process of C2, after neck hyperextension.