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Neurosurg Rev ; 22(2-3): 121-3, 1999 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-10547011

RESUMO

Vascular lesions without clinical manifestation may occur in cranial-facial wounds produced by bullets that course the base of the cranium. This work describes a rare kind of vascular complication in cranial-facial gunshot wound. The authors present the case of a patient, the victim of a cranium-maxillary gunshot wound. Carotid angiography revealed a carotid-sygmoid sinus fistula that filled the sygmoid and transverse sinuses, concomitant to the arterial angiographic phase. A direct communication between the external carotid artery and the sygmoid sinus was disclosed. We are not aware of any other description of this vascular complication in cranial gunshot wound. It is important to recognize this kind of complication in cases of cranial-facial gunshot wound, because new factors harmful to the brain perfusion systems are introduced, in addition to the alterations to venous return and intracranial pressure, caused by the primary trauma. The new non-invasive vascular diagnostic methods are proving useful in filling the gap left by arteriography, which is no longer used in these cases.


Assuntos
Fístula Arteriovenosa/diagnóstico por imagem , Lesões das Artérias Carótidas/diagnóstico por imagem , Artéria Carótida Externa , Angiografia Cerebral , Cavidades Cranianas/lesões , Tomografia Computadorizada por Raios X , Ferimentos por Arma de Fogo/diagnóstico por imagem , Adulto , Lesões Encefálicas/diagnóstico por imagem , Artéria Carótida Externa/diagnóstico por imagem , Cavidades Cranianas/diagnóstico por imagem , Evolução Fatal , Humanos , Masculino
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