Traumatic internal carotid occlusion at the base of the skull
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Traumatic internal carotid artery thrombosis following head injury often leads to severe outcomes. Most patients experience major neurological deficits or death, with few making a full recovery.
Area of Science:
- Neurology
- Vascular Surgery
- Trauma Surgery
Background:
- Internal carotid artery (ICA) thrombosis can result from head trauma.
- Understanding the specific mechanisms and outcomes is crucial for patient management.
Observation:
- This report details a case of traumatic ICA thrombosis at the skull base.
- A literature review identified 23 similar cases.
Findings:
- Internal carotid artery thrombosis has two main onset sites: the petrous pyramid (often with basal skull fracture) and distal to the posterior communicating artery (with minor head trauma).
- 85% of patients suffered major neurological deficits or died.
- Only 15% of patients achieved complete recovery.
Implications:
- Traumatic internal carotid artery thrombosis is associated with a high rate of severe morbidity and mortality.
- Early recognition and management strategies are critical for improving patient outcomes.
- Further research into preventative measures and treatment protocols is warranted.
Abstract:
A case of traumatic thrombosis of the internal carotid artery at the base of the skull is reported, and 23 similar cases collected from the literature. This review shows that 85% of the patients either died or were left with major neurological deficit, and only 15% recovered completely. There were two primary sites for the onset of thrombosis. One in the petrous pyramid and usually associated with basal skull fracture, and the other immediately distal to the posterior communicating artery in patients with minor head trauma.