Additionally, CT or catheter angiography should be considered in patients with LeFort/midface fractures, cervical spine or basilar skull fractures, diffuse axonal injury with Glasgow Coma Scale (GCS) 6, a new focal neurological deficit, neurological examination incongruous with head CT findings, or imaging evidence of a new cerebral infarct in the setting of trauma. In some situations, a stent may be sufficient to divert flow, allowing the pseudoaneurysm to thrombose without coil deployment.16-18 Some controversy persists regarding the risks and benefits of stent placement, with long-term stent occlusion rates reported in up to 45% of patients in early series.19 Discussion continues about the ideal timing of treatment, perceived benefits of different stent features, and optimal concomitant antiplatelet therapy in these patients.20 Traumatic arteriovenous fistulae can occur in the setting of arterial transection, with resulting communication between the injured artery and adjacent vein.
Angiographic evaluation and treatment for head and neck vascular injury Julie Bykowski, MD, and Wade Wong, DO, FACR, FAOCR A variety of head and neck vas- cular emergencies, such as nosebleeds or neoplastic hem- orrhages, can occur spontaneously or result from blunt or penetrating trauma. As most traumatic venous bleeding can be resolved with direct pressure, the main focus is on
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