Laceration Arterial

Penetrating and non-penetrating neck injuries are more likely to damage the carotid than the better protected vertebral artery. The vertebral artery appears to be more vulnerable to rotational and hyperextension injuries of the neck, particularly at the level of the atlas and axis. Laceration, dissection and intimal tears may be complicated by thrombosis and then embolism and, therefore, ischemic stroke at the time of the injury or some days or even weeks after the injury. Later stroke may be a consequence of the formation of a traumatic aneurysm, arteriovenous fistula or a fistula between the carotid and vertebral arteries (Davis and Zimmerman 1983). 

In pediatric patients, the intraosseous route can be used temporarily if no other route is available. Lastly, the intracardiac route is no longer recommended for patients of any age because of potential complications such as myocardial laceration, coronary artery laceration, hemopericardium, and pneumopericardium. 

Head Soft tissue injury Tender, thickened, or pulseless temporal artery Obliteration of flow through the trochlear artery with compression of the preauricular or supraorbital vessels Anhidrosis Tongue laceration Head trauma Temporal arteritis ICA occlusion or severe stenosis with retrograde ophthalmic flow CCA dissection with damage to sympathetic fibers or brainstem stroke with interruption of sympathetic tract Consider seizure as the cause of the neurologic deterioration... 

Fig. 9.8. Angiogram of left uterine artery contrast media extravasation from a vaginal laceration (arrows)...

The overall incidence ofpriapismis 1.5 per 100000 person-year [1]. Priapism is broadly classified as high-flow and low-flow. Arterial high-flow priapism (HFP) is usually secondary to the laceration of a cavernous artery with unregulated flow into the lacunar spaces. This type of priapism is most of the times not painful because there is no ischemia. HFP is rare and only 200 cases have been reported in the literature. Nonetheless, because it is painless, it is possible that HFP is under reported. The other type is veno-occlusive priapism which is usually caused by corporeal veno-occlusion, and can be very painful due to ischemia. 

Pneumothorax Hemothorax Hemopneumothorax Laceration, subclavian artery Arteriovenous fistula... 

At ultrasound, an irregular hypoechoic region within the echogenic cavernous tissue is usually identified, consistent with cavernosal tissue laceration, extravasation of blood from the torn arterial vessel and distension of the lacunar spaces... 

Shamloul R, Kamel I (2005) A broken intracavernous needle successful ultrasound-guided removal. J Sex Med 2 147-148 Witt MA, Goldstein I, Saenz de Tejada I, et al (1990) Traumatic laceration of intracavernosal arteries the pathophysiology of nonischemic, high flow, arterial priapism. J Urol 143 129-132... 

Fig. 4.3. CT scan of the liver 1 week after hepatic artery embolization as treatment for a traumatic liver laceration. The CT reveals a subcapsular fluid collection and an intraparenchy-mal, air-containing abscess in the right lobe of the liver...

Vascular Injury to main renal artery or vein with contained Hemorrhage Laceration Completely shattered kidney, ureteropelviceal avulsion Vascular Avulsion of renal hilum, devascularizing kidney... 

Arterial cut-off Mural irregularities or flap Laceration Thrombosis Dissection Free-flow contrast extravasation Stagnant intraparenchymal accumulation of contrast Parenchymal blush Stagnant arterial or venous flow Diffuse vasoconstriction Pseudoaneurysm Arteriovenous fistula Vessel displacement Free-flow contrast extravasation Stagnant intraparenchymal accumulation of contrast Disruption of visceral contour Displaced organ Intraparenchymal avascular zones... 

Fig. 20.7. Massive EPX with hemodynamic instability following maxillofacial trauma. A large false aneurysm due to a vascular laceration of the distal internal maxillary artery (asterisk) is detected. After microcatheterization of the pathological arterial segment, it is embolized with proximal glue deposition, with rapid hemodynamic stabilization and control of the EPX...

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