INTERNAL CAROTID TROMBOSIS CAUSED BY TRAUMA: CASE REPORT

CARLOS FREDERICO DE ALMEIDA RODRIGUES, CAROLINE SOLANA DE OLIVEIRA, EMELY ARCE, GUSTAVO SCHELLE, ISADORA CAVENAGO FILLUS

Resumo


Introduction: The head strokes in childhood are – in about half of the cases – related to underlying
diseases, speciallycardiopaties. Multiple variables can coexist andbe added as pro-trombosis factors.
When the symptoms are related to internal carotid artery (ICA) trombosis, they can occur from one to
sixty hours after lesion, andit’s known the middle cerebral artery (MCA) is the most affected one, resulting
in contralateral hemiparesis, homonymous hemianopsia and aphasia. In cases of hemorrhage head stroke
after oral trauma –very rare – it’s necessary to investigate some diseases that can lead to that event in
the presence of a trigger. This clinical case – approved by the ethic committee of PatoBranco Hospital,
which is located in Parana State – refers to a child, aged one year and seven months, male, with no known
disease. He went to the Hospital with a story of fall from his own height that occurred 7 hours before,
with a wound in the palate caused by a pencil. He cried while stimulating, was drowsy and hemiparethic
in the right side. He was sent from another health unity, where proceeded the palate suture and after this
went home (with no neurologic deficit). After the ictal episode, he ran head tomography, MRI, transcranial
Doppler.He ranalso screening laboratory tests (resulted negative). Head CT was normal. His MRI showed
an ischemic lesion in the territory of left MCA. TCD showed lesion in the intimal layer of ICA and MCA,
with the reestablishing of blood flow.Objectives: Report a case of trombosissencondary to an
oropharyngeal trauma.Material and Methods: Analysis of records, interview, diagnostic methods,
literature review. Discussion and Conclusion: Intraoral lesions are common in the children population and
the reported causes include sharp objects. The possibility of a neurologic complication is rare, but real. In
most part of cases, the object does not pierce the artery but can lead to trombogenesis. The therapy is
controversial, the studies show no difference between anticoagulation or not. Surgical approaches have
different results.

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