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Carotid artery thrombosis and stroke after blunt pharyngeal injury
K P Moriarty1, B H Harris, K Benitez-Marchand
1Division of Pediatric Surgery, Tufts University, Boston, Massachusetts, USA.
The Journal of Trauma
|March 1, 1997
Insights
A child
Area of Science:
- Pediatric neurology
- Vascular surgery
- Otolaryngology
Background:
- Pharyngeal injuries are uncommon in children.
- Cerebrovascular accidents (CVAs) can occur secondary to trauma.
- Internal carotid artery (ICA) thrombosis is a rare but serious complication.
Observation:
- A 2-year-old child sustained a pharyngeal injury from falling on a toothbrush.
- Delayed onset (18 hours) of cerebrovascular accident symptoms, including internal carotid artery occlusion and cerebral infarction, was observed.
- The patient presented with neurological deficits consistent with a stroke.
Findings:
- Magnetic resonance angiography confirmed internal carotid artery occlusion and cerebral infarction.
- The child received anticoagulation therapy.
- Complete neurological recovery was achieved following treatment.
Implications:
- Pharyngeal trauma can precipitate internal carotid artery thrombosis and embolism, leading to stroke in children.
- Prompt diagnosis and management, including anticoagulation and consideration of carotid artery exploration, are crucial.
- This case highlights the importance of recognizing vascular complications following seemingly minor pharyngeal injuries.
Abstract:
A 2-year-old child fell on a toothbrush, sustaining a pharyngeal injury. Eighteen hours later, localizing symptoms of a cerebrovascular accident became evident. Magnetic resonance angiography showed occlusion of the internal carotid artery and a cerebral infarction. She was treated with anticoagulation and made a complete recovery. Pharyngeal injuries may be complicated by internal carotid artery thrombosis and embolus. Management includes prompt diagnosis, anticoagulation, and carotid artery exploration in selected cases.