Traumatic bilateral carotid artery dissection

Bilateral carotid artery dissection following blunt trauma is a rare but potentially lethal injury if not diagnosed early and treated.

We report a collision patient who suffered bilateral asymptomatic carotid artery dissections. He also had multiple fractures of the pelvis and upper and lower extremities. The patient was managed acutely with aspirin. He underwent open reduction and internal fixation of fractures without complication and was discharged home on aspirin.

Carotid artery dissections are increasingly being recognized in blunt trauma patients. Management options include systemic anticoagulation versus antiplatelet therapy. The need to acutely address the carotid artery injury must be balanced with the need for hemostasis with associated solid organ injury and/or future operative procedures.

Carotid artery dissections should be screened for in patients with appropriate mechanism of injury. This case report details the successful management of a patient of bilateral carotid artery dissection and other major orthopedic injuries using aspirin.