Management of carotid artery transection resulting from a stab wound to the ear

Emergency treatment of penetrating injury to the internal carotid artery at the skull base and within the temporal bone is difficult due to problems of exposure and control of this vessel. A successful method of management of a patient whose carotid artery was completely transected by a stab wound to the ear is presented. This involved gaining proximal vascular control in the neck and distal control intracranially. Indications for extracranial-intracranial vascular bypass procedures are discussed.