Carotid artery injury with cerebral infarction following head and neck blunt trauma: report of a case.
Blunt injury to the carotid artery is rare but may produce a devastating outcome with longterm morbidity. Initial recognition by clinicians is often difficult because of the diverse clinical manifestations, the delay in presentation of symptoms, and the associated multi-organ system injuries that accompany carotid injury. Early diagnosis and successful management of traumatic carotid artery injury require a high index of clinical suspicion. We report herein a 20-year-old male victim of internal carotid artery injury induced by a motorcycle accident, who initially presented with a clear consciousness and had normal computed tomogram (CT) of brain. Two days after injury, the patient suffered from left hemiplegia and coma. The follow-up brain CT showed acute infarction of right cerebrum and severe cerebral edema. Emergency craniotomy for brain decompression and anticoagulation therapy was carried out. After a three-month treatment, he was discharged and underwent regular follow-up in the outpatient department. Six months later, the patient had intact awareness but remained in a left-sided hemiparetic state.
Liu
Wen-Pin
WP
Department of Emergency Medicine, China Medical University Hospital, Yuanlin, Changhua, Taiwan.
Ng
Kim-Choy
KC
Hung
Jheng-Jing
JJ
D000063:Accidents, Traffic; D000328:Adult; D020212:Carotid Artery Injuries / Q000175:diagnosis* / Q000209:etiology*; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D003399:Craniotomy; D003937:Diagnosis, Differential; D016489:Head Injuries, Closed / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D008297:Male; D016896:Treatment Outcome