675 ICA Ligation and Malignant MCA Syndrome Secondary to A Gunshot Wound: A Case Presentation
نویسندگان
چکیده
Abstract Penetrating carotid injuries occur infrequently in the UK. Without surgical intervention, mortality rates are close to 100%. Whilst vessel repair is optimal choice, zone III neck or haemodynamic instability particular often require ligation, which carries higher rates, increased risk of stroke and poorer outcomes overall. We present a young patient who sustained gunshot wound neck. Emergency exploration revealed penetrating injury left side complete transection internal artery. Due instability, damage control surgery was mandated, artery ligated. The admitted ITU but had severe acute neurological deterioration post-operation. CT head imaging large frontal-parietal infarct with rightward midline shift, keeping malignant MCA syndrome. He underwent an emergency decompressive craniectomy, resolution shift seen on subsequent imaging. At 3 months, walked independently out hospital, reduction his modified Rankin Scale score from 5 2 following intensive therapies input. rare, importance timely recognition intervention infrequent complication ligation paramount. Decompressive craniectomy mainstay treatment for syndrome, yet remain poor all ages, highlighting patient’s noteworthy recovery. Though emerging evidence suggests novel endovascular techniques may provide favourable reduced complications injuries, open remains choice.
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ژورنال
عنوان ژورنال: British Journal of Surgery
سال: 2021
ISSN: ['1365-2168', '0007-1323']
DOI: https://doi.org/10.1093/bjs/znab259.313