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A Case of Bilateral Carotid Injury Caused by Vinyl Umbrella Penetration Successfully Treated with Endovascular Therapy Tatsuki MOCHIZUKI 1 , Bikei RYU 1,2 , Shinsuke SATO 1,2 , Shogo SHIMA 1 , Tatsuya INOUE 1,2 , Kentaro KUWAMOTO 1 , Yasunari NIIMI 2 , Yoshikazu OKADA 1 1Department of Neurosurgery, St. Luke's International Hospital 2Department of Neuroendovascular therapy, St. Luke's International Hospital Keyword: carotid artery injuries , neck trauma , endovascular treatment pp.677-682
Published Date 2021/5/10
DOI https://doi.org/10.11477/mf.1436204442
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 Here, we have reported a case pertaining to a 59-year-old man with bilateral traumatic carotid artery injury caused by vinyl umbrella penetration who was successfully treated. The patient fell from the stairs while holding an umbrella, which penetrated his neck. On admission, the patient was in a comatose state and the umbrella had been removed. Active bleeding was observed on the left side of the neck. Hence, tracheal intubation was performed to support respiration. Neck and head contrast-enhanced CT revealed bilateral extravasations from the carotid arteries and right middle cerebral artery(MCA)occlusion. Left carotid angiography showed extravasation from the external carotid artery(ECA), which was treated with coil embolization. Right carotid angiography revealed bleeding from the ECA and internal carotid artery(ICA)and occlusion of the MCA. The ECA and ICA were occluded by coil and n-butyl-2-cyanoacrylate embolization. After the procedures, the patient developed a large right cerebral infarction with massive brain swelling;therefore, external decompression was performed. Subsequently, the patient became alert and was able to walk with support within a month.

 Bilateral carotid injury is severe and difficult to treat. Endovascular therapy may be effective for the management of bilateral carotid injuries.


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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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