A case report of blunt intraoral cerebrovascular injury in a child following intraoral trauma: The pen is mightier than the sword

Abstract

Carotid artery dissection in the paediatric population is uncommon and in rare cases it can be due to intraoral blunt trauma associated with a stick-like object such as pen or chopstick in the mouth at the time of injury. Given the rarity of the condition, there is significant knowledge gap in evidence-based diagnosis and management of paediatric blunt cerebrovascular injury (BCVI). This case report presents a rare case of asymptomatic carotid artery dissection due to intraoral blunt trauma in a young patient and the successful conservative management. This report also demonstrated the sonographic progression of the carotid artery dissection on follow up imaging.

Blunt Cerebrovascular Injury with Delayed Ischemic Stroke - A Case Report with Discussion on Diagnosis and Management

“…It can occur in falls from height, strangulation, contact sports injuries, and trauma to the oropharynx with a penetrating object. 4,5 Very rarely it can occur in low-velocity injuries as in maneuvers by a chiro practitioner, and yoga posture. It has also been reported in nose blowing, and vomiting, although the exact mechanism has not been explained.…”

Traumatic carotid artery injury caused by a metal sipping straw in a pediatric patient: Anesthetic management and considerations

“…Intraoral injury accounted for only 7 cases of traumatic carotid dissection in a review of 34 case reports published between 1961 and 2007. Within this cohort all 7 patients were reported to have an intact neurological status immediately post injury [ 1 ]. Thoughtful surgical and anesthetic management is vital to achieve the best outcomes in these rare cases.…”