CTICasesTraumatic Innominate Artery Injury with Pseudoaneurysm
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Imaging findings
An 18-year-old motor vehicle crash victim showed abnormal left paratracheal widening and extension to the left apex on chest radiograph, indicative of mediastinal hematoma. CT demonstrated focal irregularity and disruption at the root of the innominate artery with associated thrombus. A minimally displaced right posterior first rib fracture was also present. Follow-up CT revealed a pseudoaneurysm at the innominate artery. The patient suffered bilateral middle cerebral artery infarcts.
Key takeaways
Traumatic innominate artery injury, a severe consequence of blunt chest trauma, can present with mediastinal hematoma and lead to pseudoaneurysm formation and embolic complications such as stroke. Radiographic signs like paratracheal widening should raise suspicion, especially when associated with first rib fractures.
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