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首页> 外文期刊>Otology and neurotology: official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology >Analysis of carotid artery injury in patients with basilar skull fractures.
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Analysis of carotid artery injury in patients with basilar skull fractures.

机译：分析基底颅骨骨折患者的颈动脉损伤。

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OBJECTIVES: : Determine the prevalence of carotid artery injury (CAI) in patients with basilar skull fractures and describe significant demographic and radiographic risk factors for CAI. STUDY DESIGN: : From January 2004 to December 2008, medical records of 1,279 consecutive adult patients treated for basilar skull fractures at a tertiary care academic hospital were retrospectively reviewed. Diagnostic angiography was performed in 112 patients because of concern for CAI. Computed tomographic studies of the head and cranial base were reviewed for evidence of pneumocephalus, petrous carotid canal fractures, and sphenoid bone fractures. RESULTS: : Mean age of patients undergoing angiography was 38.7 years, and 85 patients (75.9%) were male subjects. Thirty-five (50%) of 70 discrete cerebrovascular injuries on angiography involved the carotid canal. The prevalence of CAI in patients with basilar skull trauma was 2.0%. CAI was associated with female sex (p = 0.001), whereas lower Glasgow Coma Scale score approached statistical significance (p = 0.07). Sensitivity and specificity of the 3 computed tomographic findings individually were 44% to 68% and 41% to 67%, respectively. With all 3 findings concurrently, 85% specificity and 80% negative predictive value for CAI were obtained, although sensitivity declined. CONCLUSION: : The frequency of CAI in patients with basilar skull fractures was higher than that in those without basilar skull involvement. Female sex was strongly associated with CAI. The intimate anatomic relationship between the carotid artery and the cranial base posit substantial diagnostic and therapeutic challenges for the contemporary cranial base surgeon, and thus, understanding the epidemiology and risk factors for CAI is of paramount importance.
机译：目标：：确定基底颅骨骨折患者颈动脉损伤（CAI）的患病率，并描述了CAI的显着人口统计学和放射线危险因素。研究设计：从2004年1月到2008年12月，回顾了第三纪念医院的1,279例经治疗基底骨骨折的成年患者的病历。由于关注CAI，在112例患者中进行了诊断血管造影。对头部和颅底的计算机断层扫描研究进行了审查，以获取肺头，颈动脉骨折和蝶骨骨折的证据。结果：：接受血管造影的患者的平均年龄为38.7岁，男性受试者85例（75.9％）。 70个离散的脑血管损伤中，有35个（50％）在血管造影上涉及颈动脉管。基底颅骨创伤患者CAI的患病率为2.0％。 CAI与女性性别有关（p = 0.001），而较低的格拉斯哥昏迷评分接近统计显着性（p = 0.07）。三个计算机断层扫描结果的敏感性和特异性分别为44％至68％和41％至67％。在所有3个发现同时，尽管灵敏度下降，但获得了CAI的85％特异性和80％的负预测值。结论：：基底颅骨骨折患者的CAI频率高于没有基底颅骨受累的患者。女性与CAI密切相关。颈动脉与颅底之间的亲密解剖关系对当代颅底外科医生带来了重大诊断和治疗性挑战，因此了解CAI的流行病学和危险因素至关重要。

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