Extracranial traumatic carotid artery dissections in children

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dc.contributor.author Chamoun, Roukoz B.
dc.contributor.author Mawad, Michel E.
dc.contributor.author Whitehead, William E.
dc.contributor.author Luerssen, Thomas G.
dc.contributor.author Jea, Andrew
dc.date.accessioned 2019-07-12T09:11:17Z
dc.date.available 2019-07-12T09:11:17Z
dc.date.copyright 2008 en_US
dc.date.issued 2019-07-12
dc.identifier.issn 1933-0693 en_US
dc.identifier.uri http://hdl.handle.net/10725/11049
dc.description.abstract Object Currently, no diagnostic or treatment standards exist for extracranial carotid artery dissection (CAD) in children after trauma. The purpose of this study was to review and describe the characteristics, diagnosis, and treatment of this rather uncommon sequelae of pediatric trauma. Methods A systematic review of the literature was performed to examine the pertinent studies of traumatic extracranial carotid artery (CA) injuries in children. Results No randomized trials were identified; however, 19 case reports or small case series consisting of 34 pediatric patients were found in the literature. The diagnosis of CAD was made in 33 of 34 patients only after the onset of ischemic symptomatology. Twenty-four of 34 patients underwent cerebral angiography to confirm diagnosis; MR angiography affirmed the diagnosis in 6 of 34 patients. There was little published experience with CA ultrasonography or CT angiography for diagnosis. Thirty of 34 patients were treated with medical therapy or observation; 2 of 4 patients treated with observation alone died. There was little experience with open surgical treatment of CAD in the pediatric population, and there were no studies on the endovascular treatment of traumatic CAD in children. The literature does not support anticoagulation therapy over antiplatelet therapy. Conclusions As a result of this review of the literature, the authors propose the algorithms for the evaluation and treatment of traumatic extracranial CADs in children. These recommendations include utilizing MR angiography as a screening tool in cases in which the clinical suspicion of CAD is high, using conventional cerebral angiography to confirm the diagnosis, implementing antiplatelet therapy as initial medical management, and reserving endovascular stenting in cases of failed medical treatment. en_US
dc.language.iso en en_US
dc.title Extracranial traumatic carotid artery dissections in children en_US
dc.type Article en_US
dc.description.version Published en_US
dc.title.subtitle a review of current diagnosis and treatment options en_US
dc.author.school SOM en_US
dc.author.idnumber 201700518 en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Journal of Neurosurgery en_US
dc.journal.volume 2 en_US
dc.journal.issue 2 en_US
dc.article.pages 101-108 en_US
dc.identifier.ctation Chamoun, R. B., Mawad, M. E., Whitehead, W. E., Luerssen, T. G., & Jea, A. (2008). Extracranial traumatic carotid artery dissections in children: a review of current diagnosis and treatment options. Journal of Neurosurgery: Pediatrics, 2(2), 101-108. en_US
dc.author.email michel.mawad@lau.edu.lb en_US
dc.identifier.tou http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php en_US
dc.identifier.url https://thejns.org/pediatrics/view/journals/j-neurosurg-pediatr/2/2/article-p101.xml en_US
dc.author.affiliation Lebanese American University en_US

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