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Blunt carotid arterial trauma
R D Laitt1, T T Lewis, J R Bradshaw
1Department of Neuroradiology, Frenchay Hospital, Bristol, UK.
Clinical Radiology
|February 1, 1996
Summary
Blunt carotid artery injury is rare but serious, often presenting with delayed neurological symptoms like stroke after head trauma. Early diagnosis via angiography is crucial for treatment and preventing long-term disability.
Area of Science:
- Vascular Surgery
- Trauma Surgery
- Neurology
Background:
- Blunt neck trauma can cause carotid artery injury, including dissection or pseudoaneurysm.
- These injuries are uncommon but lead to severe outcomes like stroke.
- External signs of trauma are often absent, delaying diagnosis.
Purpose of the Study:
- To identify the incidence and presentation of blunt carotid artery injuries in head and neck trauma patients.
- To highlight the diagnostic challenges and the importance of timely intervention.
Main Methods:
- Retrospective review of 2024 head and neck trauma patients over seven years.
- Analysis of eight patients (0.4%) diagnosed with blunt carotid artery injury.
- Clinical evaluation, CT/MRI, and cerebral angiography.
Main Results:
- Seven cases of carotid artery dissection and one pseudoaneurysm were identified.
- Neurological deficits often appeared after a latent period (4 hours to 75 days).
- Initial CT scans were normal; angiography confirmed the diagnosis.
Conclusions:
- Blunt carotid artery injuries are underdiagnosed, especially when external neck trauma is absent.
- Patients with neurological deficits after head/neck trauma require urgent angiography to rule out vascular injury.
- Early diagnosis and treatment of carotid injury can prevent cerebral infarction and improve outcomes.