Carotid artery injury produced by blunt neck trauma

Three patients with extracranial carotid artery injury are presented. The trauma to the neck was blunt and nonpenetrating. Two patients showed the progressive neurologic signs of an intracranial lesion three and seven days respectively after head injuries. Injury to the neck did not appear to be a factor in one and, at most, a minor factor in the other. The provisional diagnostic impression in each instance was subdural hematoma. The third case was found in a patient with brain contusion, fractured mandible, and severe neck contusion, who was investigated by contrast study when he failed to respond. All three patients showed compromise of the lumen of an extracranial internal carotid artery on arteriography and on exploration. Two reacted promptly and well to surgical intervention. The third recovered slowly from the brain contusion, but we believe that additional complications were averted by appropriate intervention.