Blunt carotid artery injuries

Alex A. Parikh, Fred A. Luchette, John F. Valente, Robert C. Johnson, Gary L. Anderson, John Blebea, Gary J. Rosenthal, James M. Hurst, Jay A. Johannigman, Kenneth Davis

Research output: Contribution to journalArticlepeer-review

103 Scopus citations

Abstract

Background: Blunt carotid artery trauma remains a rare but potentially devastating injury. Early detection and treatment remain the goals of management. Our objective was to identify patients sustaining blunt carotid injuries at a regional trauma center and report on the incidence, demographics, diagnostic workup, management, and outcome. Study Design: A retrospective chart review was performed of patients sustaining blunt carotid artery injury between 1990 and 1996. Results: Twenty patients were identified during the 7-year period. All patients suffered blunt trauma, with motor vehicle accidents being the most common mechanism, and the internal carotid the most frequently injured vessel. Associated injuries were present in all patients, with head (65%) or chest (65%) injuries being the most common. The combination of head and chest trauma (45%) was found to be associated with a 14-fold increase in the likelihood of carotid injury. Cerebral angiography was diagnostic in all patients and the majority were treated nonoperatively with anticoagulation. Twenty percent of patients were discharged with a normal neurologic exam, while 45% left with a significant neurologic deficit. Overall mortality was 5%. Conclusions: Blunt carotid injuries are rare but are associated with significant morbidity and mortality. The combination of craniofacial and chest wounds should raise the index of suspicion for blunt carotid injury. Anticoagulation was associated with the least morbidity.

Original languageEnglish
Pages (from-to)80-86
Number of pages7
JournalJournal of the American College of Surgeons
Volume185
Issue number1
DOIs
StatePublished - 1997

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