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Annals of Surgery logoLink to Annals of Surgery
. 1980 Jul;192(1):74–77. doi: 10.1097/00000658-198007000-00013

Carotid artery injuries caused by blunt trauma.

M O Perry, W H Snyder, E R Thal
PMCID: PMC1344809  PMID: 7406566

Abstract

Carotid artery injuries caused by blunt trauma often cause thrombosis and delayed neurologic deficits, and are associated with mortality rates of up to 40%. In this series of 17 patients with blunt trauma of the carotid, three had no symptoms, ten patients had limb paresis and four had severe neuroligic deficits. The wounds were identified by arteriography; repair was attempted in 15 patients, and successful in eight. All eight patients with successful repair were improved or normal after surgery, but only two out of nine patients without repair improved, and four died. The mortality rate for the series was 23%, but only 14% in the patients who had carotid surgery. This experience suggests that repair is safe and effective in patients with carotid injuries in whom prograde flow continues and only mild neurologic deficits are present. In contrast, patients with complete occlusion, severe neurologic problems, and altered consciousness are not likely to be helped by attempts at revascularization.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bland J. E., Perry M. O., Clark K. Spasm of the cervical internal carotid artery. Ann Surg. 1967 Dec;166(6):987–989. doi: 10.1097/00000658-196712000-00016. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bradley E. L., 3rd Management of penetrating carotid injuries: an alternative approach. J Trauma. 1973 Mar;13(3):248–255. doi: 10.1097/00005373-197303000-00012. [DOI] [PubMed] [Google Scholar]
  3. CALDWELL H. W., HADDEN F. C. Carotid artery thrombosis; report of eight cases due to trauma. Ann Intern Med. 1948 Jun;28(6):1132–1142. doi: 10.7326/0003-4819-28-6-1132. [DOI] [PubMed] [Google Scholar]
  4. Cohen C. A., Brief D., Mathewson C., Jr Carotid artery injuries. An analysis of eighty-five cases. Am J Surg. 1970 Aug;120(2):210–214. doi: 10.1016/s0002-9610(70)80113-1. [DOI] [PubMed] [Google Scholar]
  5. Crissey M. M., Bernstein E. F. Delayed presentation of carotid intimal tear following blunt craniocervical trauma. Surgery. 1974 Apr;75(4):543–549. [PubMed] [Google Scholar]
  6. DiVincenti F. C., Weber B. B. Traumatic carotid artery injuries in civilian practice. Am Surg. 1974 May;40(5):277–280. [PubMed] [Google Scholar]
  7. Goldstone J., Moore W. S. Emergency carotid artery surgery in neurologically unstable patients. Arch Surg. 1976 Nov;111(11):1284–1291. doi: 10.1001/archsurg.1976.01360290118018. [DOI] [PubMed] [Google Scholar]
  8. González A. Common carotid artery stenosis due to subintimal hematoma following blunt trauma to the neck. Report of a case. J Cardiovasc Surg (Torino) 1977 May-Jun;18(3):297–301. [PubMed] [Google Scholar]
  9. Gurdjian E. S., Audet B., Sibayan R. W., Thomas L. M. Spasm of the extracranial internal carotid artery resulting from blunt trauma demonstrated by angiography. Case report. J Neurosurg. 1971 Dec;35(6):742–747. doi: 10.3171/jns.1971.35.6.0742. [DOI] [PubMed] [Google Scholar]
  10. Jernigan W. R., Gardner W. C. Carotid artery injuries due to closed cervical trauma. J Trauma. 1971 May;11(5):429–435. doi: 10.1097/00005373-197105000-00008. [DOI] [PubMed] [Google Scholar]
  11. Liekweg W. G., Jr, Greenfield L. J. Management of penetrating carotid arterial injury. Ann Surg. 1978 Nov;188(5):587–592. doi: 10.1097/00000658-197811000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Little J. M., May J., Vanderfield G. K., Lamond S. Traumatic thrombosis of the internal carotid artery. Lancet. 1969 Nov 1;2(7627):926–930. doi: 10.1016/s0140-6736(69)90589-3. [DOI] [PubMed] [Google Scholar]
  13. Monson D. O., Saletta J. D., Freeark R. J. Carotid vertebral trauma. J Trauma. 1969 Dec;9(12):987–999. doi: 10.1097/00005373-196912000-00003. [DOI] [PubMed] [Google Scholar]
  14. Payan H. M. Ill-effects of carotid artery ligation: experimental study on influence of age. Ann Surg. 1967 Apr;165(4):544–550. doi: 10.1097/00000658-196704000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Popp A. J., Chater N. Extracranial to intracranial vascular anastomosis for occlusive cerebrovascular disease: experience in 110 patients. Surgery. 1977 Nov;82(5):648–654. [PubMed] [Google Scholar]
  16. Thal E. R., Snyder W. H., 3rd, Hays R. J., Perry M. O. Management of carotid artery injuries. Surgery. 1974 Dec;76(6):955–962. [PubMed] [Google Scholar]
  17. Yamada S., Kindt G. W., Youmans J. R. Carotid artery occlusion due to nonpenetrating injury. J Trauma. 1967 May;7(3):333–342. doi: 10.1097/00005373-196705000-00001. [DOI] [PubMed] [Google Scholar]
  18. Zilkha A. Traumatic occlusion of the internal carotid artery. Radiology. 1970 Dec;97(3):543–548. doi: 10.1148/97.3.543. [DOI] [PubMed] [Google Scholar]

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