A case of traumatic internal carotid artery obstruction after maxillofacial trauma

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  • 顎顔面外傷に続発した外傷性内頸動脈血栓症の1例
  • ガク ガンメン ガイショウ ニ ゾクハツ シタ ガイショウセイ ナイ ケイドウミャク ケッセンショウ ノ 1レイ

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Traumatic internal carotid artery obstruction developing after maxillofacial trauma is difficult to diagnose.<br>We report the case of 16-year-old woman with traumatic internal carotid artery obstruction following a mandibular fracture. She was hospitalized for a mandibular fracture after getting involved in a traffic accident. Although her condition was satisfactory immediately after hospitalization, she suddenly developed disturbed consciousness and exhibited symptoms of left-sided paralysis 12 hours after injury. Magnetic resonance angiography (MRA) revealed obstruction of the internal carotid and middle cerebral arteries on the right side. She was transferred to an emergency care center 15 hours after injury and underwent thrombectomy and hemostasis for cerebral hemorrhe. The mandibular fracture was monitored given her unstable physical condition and signs of restlessness accompanying disturbed consciousness. She recovered fully without any pronounced dysfunction or cosmetic disturbance.<br>This case shows that traumatic injury resulting in cervical hyperextension or hyperflexion can cause internal carotid artery obstruction. These findings underscore the importance of careful follow-up in patients with mandibular fracture, regardless of whether they present with apparent head injury, given the possibility of traumatic internal carotid artery obstruction.

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