Study of the treatment strategy of cerebral infarction caused by blunt internal carotid artery injuries resulting from maxillofacial trauma: a report of 8 cases

doi:10.19438/j.cjoms.2017.01.017

Abstract

Abstract: PURPOSE: To estimate the treatment strategies of cerebral infarction with severe maxillofacial trauma resulting in blunt internal carotid artery injuries (BCAIs). METHODS: The clinical data of 8 patients with cerebral infarction caused by BCAIs were retrospectively analyzed between January 2008 and December 2013. RESULTS: Of 8 patients, 6 were male and 2 were female, aged 19-54 years (mean 36±11.95 years). The time from injury to admission was 5-8 hours (mean 6.31±1.00 hours). All patients were awake after injury and presented with neurologic ischemia at admission, 6 cases with drowsiness, 2 cases with semicoma (1 case developed coma one day later) and 6 cases with hemiparalysis. Eight cases with facial fractures were diagnosed by CT scans, and 2 cases with skull base fractures, 1 case with mandible fracture. The ischemic lesions involved in internal carotid artery supply area and no intracranial hemorrhage was identified following head and neck CT scans. All 8 patients received aspirin 300 mg/d for 2 weeks and 100 mg for the following 6 months, and 1 case underwent craniotomy. For GOS scores 6 month after injury, 6 cases had good recovery, 1 case was with moderate disability, 1 case was with severe disability and no case died. CONCLUSIONS: The patients with blunt internal carotid artery injuries complicated by maxillofacial fractures should be diagnosed in early stage, and the application of antiplatelet therapy could reduce BCAIs stroke-related morbidity and mortality.

Key words: Cerebral infarction, Maxillofacial fractures, Internal carotid artery, Blunt injury, Antiplatelet therapy

CLC Number:

R782.4

CHENG Zhi-hua, OUYANG Huo-niu, LUO Cong, GUO Yu, GUO Zhi-lin. Study of the treatment strategy of cerebral infarction caused by blunt internal carotid artery injuries resulting from maxillofacial trauma: a report of 8 cases[J]. China Journal of Oral and Maxillofacial Surgery, 2017, 15(1): 77-79.

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