Carotid artery injury caused by blunt cervical trauma. Case report

Three cases of carotid artery injury following blunt cervical trauma are reported and the literature is reviewed. The condition carries high morbidity and mortality rates, due to occlusion of the internal carotid artery. The diagnosis is often delayed, as the symptoms of carotid injury frequently are mistakenly attributed to head injury. The insidious course, with neurologic deficit developing in an alert patient prior to lowering of consciousness, distinguishes blunt carotid artery injury from head injury. Aortic arch angiography is crucial for the diagnosis, and should be frequently performed in patients who have sustained blunt cervical trauma. Normal computed tomography of the brain does not exclude ischaemic cerebral infarction, visualization of which requires several days. Tomography of the neck following intravenous injection of contrast medium may be useful for demonstrating occlusion of the carotid artery. Heightened awareness of this injury is important for early diagnosis. Immediate revascularization may improve the poor prognosis.