title: Delayed Stroke following Blunt Neck Trauma: A Case Illustration with Recommendations for Diagnosis and Treatment.
abstract: Blunt cerebrovascular injury (BCVI) to the carotid artery is a relatively rare injury that is difficult to identify even with imaging. Any symptoms or neurological deficits following blunt neck injury mandate evaluation and consideration of BCVI. In an effort to highlight this issue, we report the case of a 31-year-old male patient who presented with left-sided weakness consistent with transient ischemic attack (TIA) and concussion. The patient's symptoms occurred within 24 hours of a blunt neck injury sustained by a knee strike during a basketball game. An initial computerized tomography (CT) scan of the brain was normal; a CT angiogram (CTA) of the neck and carotids did not reveal obstruction, dissection, stenosis, or abnormalities of the carotid or vertebral vessels and the patient was subsequently discharged. A magnetic resonance imaging (MRI) of the brain obtained four days after the initial injury demonstrated an acute infarct in the right middle cerebral artery (MCA) territory. Thus, despite initial negative imaging, neurological deficits must be aggressively pursued in order to prevent stroke in BCVI cases.
authors.affiliation: Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, FL 33140, USA; Memorial Regional Hospital, Division of Acute Care Surgery and Trauma, 3501 Johnson Street, Hollywood, FL 33021, USA.
authors.forename: Best
authors.initials: B
authors.lastname: Anyama
authors.affiliation: Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, FL 33140, USA; Memorial Regional Hospital, Division of Acute Care Surgery and Trauma, 3501 Johnson Street, Hollywood, FL 33021, USA.
authors.forename: Daniela
authors.identifier: 0000-0002-2648-7086
authors.initials: D
authors.lastname: Treitl
authors.affiliation: Nova Southeastern University, College of Osteopathic Medicine, 3301 College Avenue, Fort Lauderdale, FL 33314, USA.
authors.forename: Jeffery
authors.initials: J
authors.lastname: Wessell
authors.affiliation: Memorial Regional Hospital, Division of Acute Care Surgery and Trauma, 3501 Johnson Street, Hollywood, FL 33021, USA.
authors.forename: Rachele
authors.initials: R
authors.lastname: Solomon
authors.affiliation: Memorial Regional Hospital, Division of Acute Care Surgery and Trauma, 3501 Johnson Street, Hollywood, FL 33021, USA.
authors.forename: Andrew A
authors.identifier: 0000-0001-6069-6458
authors.initials: AA
authors.lastname: Rosenthal