PMC6015681_01
Figure 1 is an image of the wound at the right anterior neck.
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According to him, the bleeding was not profuse and stopped when he arrived at the local hospital to search for remedy (Figure 1).
(a)-(d) are CT-scan images indicating no intracranial abnormities after the injury.
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CT-scan done at the local hospital revealed C2-C4 transverse process fractures on the right side, fracture at the right lamina of C3, and right common carotid artery dissection. CT-scan of the head showed no abnormalities (Figures 2(a) and 2(b)).
(a)-(d) are DSA images showing right common carotid artery dissection and distorted right vertebral artery.
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Explorative three-dimensional reconstruction plain and enhanced scan imaging of the cervical spine, chest, and abdomen done at our facility revealed two segmental stenoses of the right common carotid artery with very pale V1 and V3 segment of the right vertebral artery as well as blockage at V2 segment (Figures 3(a)-3(d)) as well as fracture at the right lamina of C3 and C2-C4 transverse processes with free bone fragments and peripheral soft tissue swelling (Figures 4(a)-4(d)).
(a)-(d) are CTA showing the fractures at spinous processes of C2-C4 as well as right common carotid artery dissection.
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Explorative three-dimensional reconstruction plain and enhanced scan imaging of the cervical spine, chest, and abdomen done at our facility revealed two segmental stenoses of the right common carotid artery with very pale V1 and V3 segment of the right vertebral artery as well as blockage at V2 segment (Figures 3(a)-3(d)) as well as fracture at the right lamina of C3 and C2-C4 transverse processes with free bone fragments and peripheral soft tissue swelling (Figures 4(a)-4(d)).
(a)-(d) are postoperative images showing the stent in situ.
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We introduced the guiding catheter guide wire to the proximal end of the right common carotid artery with continued infusion of heparinized saline, after which we introduced a guide wire with a Cordis stent (10 * 60mm) to completely cover the right common carotid artery dissection site with stenosis and released the stent gradually until it completely filled the stenosis area (Figures 5(a)-5(d))).
(a) and (b) are control contrasted angiograph done after stenting.
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Control contrasted angiograph done revealed stenting was successful (Figures 6(a) and 6(b)).