1. Amit N. Sanghvi MD Summit Radiology
NeuroIR in Trauma
Amit N. Sanghvi MD
Summit Radiology

2. No Disclosures

3. Stop the Bleeding OR Open the Blockage

4. Blood Vessels

5. Trauma Trauma is the ninth leading cause of death worldwide.
United States, it remains the leading cause of death in individuals under the age of 45.
Predominant cause of death related to trauma is a central nervous system (CNS) injury.
Locoregional repercussions, e.g., massive neck hemorrhage, traumatic injuries head/neck
Remote complications, in particular ischemic damage to the CNS.

6. MECHANISMS OF INJURY Blunt or Penetrating Trauma
Critical nature of the blood supplied by the carotid and vertebral arteries.
Mortality rate of 50% was reported when penetrating injuries to both the carotid and vertebral arteries were present.

7. PENETRATING TRAUMA
Penetrating injury in the neck: Three Anatomic Zones
Zone I extends inferiorly from the cricoid cartilage.
Zone II cricoid to mandible.
Zone III (face) extends superiorly from the angle of the mandible to the skull base.

8. Vascular injuries
(1) intimal and/or medial damage with or without associated narrowing of the vessel lumen and/or dissection of the vessel
(2) aneurysm or pseudoaneurysm
(3) complete occlusion
(4) arteriovenous fistulua
(5) complete transection

9. Case 1
22-year-old man with gunshot wound to the face and massive nasopharyngeal hemorrhage. The patient arrived to the emergency department bleeding profusely.

10. Case 2
44-year-old man with traumatic carotid pseudoaneurysm.

11. Case 3
53-year-old man with traumatic carotid pseudoaneurysms. This patient with known fibromuscular dysplasia and bilateral carotid dissections sustained while being assaulted with a nunchaku

12. Case 4

13. Case 5

14. Avoid
THE END