Post-traumatic occlusion of the supraclinoid internal carotid artery

Intracranial occlusion of the internal carotid artery secondary to minor head or neck injury is uncommon. We report the case of an 18-year-old man who sustained a minor head and neck injury during a fist fight and developed a left hemiparesis resulting from thrombosis of the supraclinoid portion of the right internal carotid artery. Conservative inpatient treatment with low dose heparin and aspirin resulted in a gradual, steady improvement. Two months later, after an intensive program of physical therapy, the patient showed good progress; his facial weakness had lessened and his left hemiparesis was mild. Although there is no ideal treatment for internal carotid artery occlusion secondary to minor trauma, conservative treatment should be undertaken unless there are progressive or recurring ischemic symptoms, in which case an extracranial-intracranial bypass operation should be considered.