blunt carotid injury advice

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Daniel

Anticoagulate and wait - would also suggest a catheter angio first to
exclude a small fasle aneurysm - would not want to give heparin to that
situation.

What was the 5 on the GCS - 4 for eyes and 1 motor or was the motor
score 3 or better - which offers him some prognosis?

Tim
Dr Timothy C Hardcastle
M.B., Ch.B. (Stell); M. Med (Chir) (Stell); FCS (SA)
Principal Surgeon-Lecturer / Sub-specialist: Trauma and Critical Care
Deputy director: Trauma Unit and Trauma ICU
Inkosi Albert Luthuli Central Hospital / UKZN
800 Bellair Road
Mayville, Durban
 
Postal: PostNet Suite 27
Private Bag X05
Malvern, 4055
KwaZulu Natal
 
timothyhar at ialch.co.za 
 

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of daniel simon
Sent: 29 June 2008 14:19
To: trauma-list at trauma.org
Subject: blunt carotid injury advice

32 YO MVA victim, was  intubated and ventilated on site for a GCS of 7
and
maxilo-facial injury. He was evacuated to a local hospital where a Rt
chest-tube was inserted for pneumothorax. Brain CT showed sub arachnoid
hemorrhage with some small contusions , a C1 fracture was found as well.
He
was then transferred to a Level 1 Trauma Center. On admission he had a
GCS
of 5 (t) with right hemiparesis. Neck CT -angio  showed dissection of
the
left internal carotid artery. What  shall we do now?
thanks
Daniel Simon

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