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Wed May 6 14:00:57 BST 2009

if the lesion is withdrawing by time l see no need for anticoagulation,
instead l would repeat ultrasound and see the situation, but if in any
doubt, or unable to do any diagnostic test in short period of time, l would
anticoagulate him for a while, if otherwise healthy  young person... but l
don't think there is a great chance of him stroking because even in this
situation 50% lumen is more then sufficient to provide enough blood flow,
and if no major turbulence risk for endothelial injury thrombus genesis is
practically 100% not happening
if lumen doesn't spread on its own, then would consider intervening,
surgically or radiology intervention
Ante

2009/5/6 Gross, Ronald <Ronald.Gross at baystatehealth.org>

> How about an image or two?  Before I respond to this very complex issue
> that has, to my knowledge, no real definitive answer in the surgical or
> neurosurgical literature, why did you scan the patient in the first place?
>  "Post-blunt trauma" is a pretty broad category....trauma where?  Was the
> c-spine injured?  Was the blunt trauma directly to the neck?  Was this a
> seatbelt across the neck?
>
> And lastly - is the really an injury, to refer to a phrase coined by Ken
> Mattox, is this just VOMIT?
>
> Ron
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org [mailto:
> trauma-list-bounces at trauma.org] On Behalf Of khumar huseynova
> Sent: Tuesday, May 05, 2009 4:53 PM
> To: trauma-list at trauma.org
> Subject: Blunt CCA injury ina stable YOUNG pt
>
> 24M w post-blunt trauma. Stable. Has intimal dissection of common carotid
> art w 50% lumen obstruction. Asymptomatic from injury currently. No other
> injuries. What would you do-anticoagulate w LOW-dose heparin; give ASA only;
> stent; or operate?
> KH
>
>
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Blunt CCA injury ina stable YOUNG pt