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Trauma Surgeons Gone Wild: Post-Traumatic Cervical Artery Dissection

Kenji Inaba, MD and Mizuho Spangler, DO
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18:22
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Nurses Edition Commentary

Mel Herbert, MD MBBS FAAEM, Kathy Garvin, RN, and Lisa Chavez, RN
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EM:RAP 2015 November Summary 665 KB - PDF

There are currently no evidence based guidelines for evaluation or treatment in pediatric carotid artery injury or dissection. Most recommendations are derived from adult studies. Thus the best we can do is extrapolate from best evidence we have, and apply it to the unique features of pediatric populations.

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Dee B., M.D. -

I had an 11 year old come in when I was a resident. He had been bumped by a bully at school, hyperextended his neck. A day or 2 later, a Friday, parents kept him home from school. They noticed he was weak, dropping the mayonnaise bottle during the day. They didn't make much of it.

I saw him a 0200 that night when he collapsed in his hallway at home. His head CT showed complete infarct of one hemisphere. The neurosurgeon took one look at this and said, "That's a carotid artery dissection. This is not a survivable injury."

I always wondered if I would have picked up on this if the kid had presented earlier. Maybe. Maybe not. Never blow off unilateral weakness.

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Codes and Cath Labs Full episode audio for MD edition 231:38 min - 323 MB - M4AEM:RAP 2015 November Aussie Edition Australian 26:35 min - 36 MB - MP3EM:RAP 2015 November Canadian Edition Canadian 16:25 min - 23 MB - MP3EM:RAP 2015 Español Noviembre 2015 Español 72:56 min - 38 MB - MP3EM:RAP 2015 Novembre Résumé en Francais Français 53:50 min - 32 MB - MP3EM:RAP 2015 Español Noviembre 2015 1 MB - PDFEM:RAP 2015 November Board Review Answers 263 KB - PDFEM:RAP 2015 November Board Review Questions 232 KB - PDFEM:RAP 2015 November MP3 279 MB - ZIPEM:RAP 2015 November Summary 665 KB - PDF

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