J Neurocrit Care.  2023 Dec;16(2):125-126. 10.18700/jnc.230027.

Detection of neck hematoma after carotid endarterectomy by chest X-ray

Affiliations
  • 1Department of Emergency Medicine, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea
  • 2Department of Intensive Care Medicine and Neurology, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea


Figure

  • Fig. 1. (A) Chest X-ray taken before carotid endarterectomy (CEA) shows normal findings. (B) Chest X-ray taken during dyspnea after CEA shows soft tissue swelling (black arrow) with tracheal deviation (white arrow). (C) Chest X-ray taken the day after intubation shows aggravation of soft tissue swelling (black arrow).

  • Fig. 2. (A) Neck computed tomography (CT) taken after intubation shows tracheal deviation (white arrows) due to hematoma formation (yellow arrowheads) around the carotid vessels. (B) Neck CT taken 10 days later shows resorption of hematoma and improvement in tracheal deviation.


Reference

1. Brott TG, Hobson RW 2nd, Howard G, Roubin GS, Clark WM, Brooks W, et al. Stenting versus endarterectomy for treatment of carotid-artery stenosis. N Engl J Med. 2010; 363:11–23.
2. Shakespeare WA, Lanier WL, Perkins WJ, Pasternak JJ. Airway management in patients who develop neck hematomas after carotid endarterectomy. Anesth Analg. 2010; 110:588–93.
3. Ferguson GG, Eliasziw M, Barr HW, Clagett GP, Barnes RW, Wallace MC, et al. The North American symptomatic carotid endarterectomy trial: surgical results in 1415 patients. Stroke. 1999; 30:1751–8.
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