Asymptomatic Carotid Artery Dissection Caused by Blunt Trauma -Case Report-

Abstract

A 42-year-old man presented with asymptomatic traumatic carotid artery dissection 3 months after sustaining blunt injury with tracheal laceration. Magnetic resonance imaging performed as a screening procedure for asymptomatic carotid artery injury unexpectedly showed dissection of the carotid artery. Angiography confirmed carotid artery dissection with narrowing of the true lumen. Balloon angioplasty and stent placement were carried out to dilate the true lumen and isolate the false lumen from blood flow. Intravascular ultrasonographic virtual histology defined the precise anatomic structure of the lesion and identified the internal flap as fibrotic. Careful clinical assessment of patients with blunt cervical trauma may permit diagnosis of carotid artery dissection and intervention prior to the development of cerebral ischemic symptoms.

Traumatic Internal Carotid Artery Injuries: Do We Need a Screening Strategy? Literature Review, Case Report, and Forensic Evaluation

“…The authors described a case of ICA stenosis after cervical manipulation and identified neck hyperextension as the cause of the arterial lesion. In the study by Fuse et al , an indirect neck injury consequent to dropping a heavy load was the cause of ICAD, which was diagnosed three months after the trauma by a screening MRI [ 84 ]. Pezzini et al reported a case of ICAD after playing the French horn.…”

“…76 [80][81][82][83][84][89][90][91] Not specified 22 [88,99,100,103] Gunshot 3 [68,86,87] Penetrating injuries Stab wound 2 27 [86,101] Horse-riding fall 3 [46,59,60] Football 4 [24,25,76] Snowboarding 1 [75] Water-skiing/ wakeboarding 2 [25,77] Skydiving 1 [25] Basketball 1 [7] Softball 3 [73,74] Taekwondo 1 [79] CrossFit 1 [72] Bungee jumping 1 [78] Sport (with or without specific blunt trauma)…”

Bilateral Post-Traumatic Carotid Dissection as a Result of a Strangulation Injury

“…Carotid artery dissection due to blunt head or neck trauma is among the rather rare injuries, and various authors report an occurrence rate in patients 3 whereas 35% develop symptoms after more than 24 hours from the injury. 4 The symptoms may be rather heterogeneous, from simple headache, neck pain in the carotid region (carotidynia) to mild circumscribed ischemic lesions that remain practically asymtomatic, to extensive cerebrovascular events with fully developed contralateral hemiplegia.…”

Carotid Artery Dissection with Minor Trauma And Minor Symptoms

“…Carotid artery injury may not be associated with external injury. 1 Common presenting symptoms are related with the cerebral ischemia. Varying degrees of neurological deficits can be observed.…”