Case presenTaTion A 32-year old woman presented with traumatic facial injuries from a horseback riding incident.She was found to have a Glasgow Coma Score of 3T,left eyelid ptosis with a fixed-dilated pupil and a flac...Case presenTaTion A 32-year old woman presented with traumatic facial injuries from a horseback riding incident.She was found to have a Glasgow Coma Score of 3T,left eyelid ptosis with a fixed-dilated pupil and a flaccid right upper extremity.CT angiogram of the head showed complex craniofacial injuries,including a transverse fracture transecting the clivus and the left petrous temporal bone,with SAH in the suprasellar cistern.There was a bilateral engorgement of the superior ophthalmic veins,suggestive of bilateral CCF formations.Digital subtraction angiography(DSA)showed a left petrocavernous internal carotid artery dissection(ICAD).MRI of the brain demonstrated multiple embolic infarcts in the left middle cerebral artery(MCA)territory,despite therapeutic anticoagulation with heparin.展开更多
文摘Case presenTaTion A 32-year old woman presented with traumatic facial injuries from a horseback riding incident.She was found to have a Glasgow Coma Score of 3T,left eyelid ptosis with a fixed-dilated pupil and a flaccid right upper extremity.CT angiogram of the head showed complex craniofacial injuries,including a transverse fracture transecting the clivus and the left petrous temporal bone,with SAH in the suprasellar cistern.There was a bilateral engorgement of the superior ophthalmic veins,suggestive of bilateral CCF formations.Digital subtraction angiography(DSA)showed a left petrocavernous internal carotid artery dissection(ICAD).MRI of the brain demonstrated multiple embolic infarcts in the left middle cerebral artery(MCA)territory,despite therapeutic anticoagulation with heparin.
