CTICasesTraumatic Brachiocephalic Artery Injury and Intramural Hematoma
Imaging findings
Initial chest radiograph following trauma demonstrates significant tracheal deviation to the right and a widened mediastinum with apical capping. Chest CT reveals a traumatic pseudoaneurysm at the origin of the brachiocephalic artery, along with extensive mediastinal hematoma, adjacent clavicle fractures, and a traumatic aortic intramural hematoma.
Key takeaways
Traumatic brachiocephalic artery injury at its origin is a rare and potentially life-threatening complication of deceleration injury or direct osseous pinch from sternoclavicular fractures. It can present with traumatic aortic intramural hematoma and massive mediastinal hemorrhage, requiring careful distinction of procedural versus expectant conservative management.
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