Neurologic consequences of cerebrovascular injury

Robert Richardson, Farouk N. Obeid, J. David Richardson, David B. Hoyt, David H. Wisner, Gerardo A. Gomez, Kaj Johansen, Norman E. Mc Swain, John A. Weigelt, F. William Blaisdell

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Because of ongoing controversy, the issue of vascular repair or ligation for patients with cerebrovascular injuries and preoperative central neurologic deficits is frequently debated. A total of 133 patients with penetrating cerebrovascular injuries were analyzed. The frequency of preoperative neurologic deficit was 20% (27 patients). The common carotid and internal carotid arteries were the most frequently injured structures, with a 29% and 15% incidence of preoperative neurologic deficits, respectively. The results of carotid repair in all patients whose preoperative deficit was limited to weakness or paralysis were favorable (seven patients normal or improved, two patients unchanged). The results of repair in patients whose preoperative deficit was characterized by obtundation were variable (four patients improved, four patients worsened or died). The results of carotid ligation were also variable (one improved, one unchanged, three worsened or died). Limited numbers of patients with preoperative neurologic deficits and the retrospective nature of this review prohibit definite conclusions. Therefore a multicenter, prospective, randomized trial of ligation or vascular repair for comatose patients with cerebrovascular injuries is proposed.

Original languageEnglish (US)
Pages (from-to)755-760
Number of pages6
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume32
Issue number6
DOIs
StatePublished - Jun 1992

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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    Richardson, R., Obeid, F. N., Richardson, J. D., Hoyt, D. B., Wisner, D. H., Gomez, G. A., Johansen, K., Mc Swain, N. E., Weigelt, J. A., & Blaisdell, F. W. (1992). Neurologic consequences of cerebrovascular injury. Journal of Trauma - Injury, Infection and Critical Care, 32(6), 755-760. https://doi.org/10.1097/00005373-199206000-00014