title: A rare and lethal case of right common carotid pseudoaneurysm following whiplash trauma.
abstract: Whiplash trauma from a car crash is one of the most common causes of neck injury, resulting in pain and dysfunction. We report on an unusual case of post-whiplash pseudoaneurysm of the right common carotid artery, which led to acute massive hemorrhage and death days after the initial trauma. A post-mortem computed tomography angiography showed rupture of the pseudoaneurysm of the right common carotid artery with the contrast agent leaking out into the mouth. The subsequent autopsy confirmed a large hemorrhagic clot extending to the right side of the neck and mediastinum. A rupture of the right wall of the oropharynx was identified with massive bronchial hemoaspiration. The case demonstrates a rare but lethal clinical entity, and is important in providing a better understanding of the potentially fatal consequences of minor trauma, such as whiplash injury, and its physiopathological mechanisms. Thus, changing symptoms after a whiplash injury should be carefully evaluated since they can be related to the underlying severe consequences of a rapid hyperextension-hyperflexion of the neck, as in the reported case.
authors.affiliation: Department of Forensic Pathology, University of Foggia, Viale degli Aviatori 1, 71100, Foggia, Italy.
authors.forename: Cristoforo
authors.initials: C
authors.lastname: Pomara
authors.forename: Stefania
authors.initials: S
authors.lastname: Bello
authors.forename: Serenella
authors.initials: S
authors.lastname: Serinelli
authors.forename: Vittorio
authors.initials: V
authors.lastname: Fineschi
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D017542:Aneurysm, Ruptured / Q000209:etiology / Q000473:pathology; D001344:Autopsy; D020212:Carotid Artery Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology*; D002423:Cause of Death; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012771:Shock, Hemorrhagic / Q000209:etiology / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014911:Whiplash Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*