Nonpenetrating Trauma to the Carotid Artery

Unique Case of Pulsatile Tinnitus

“…10 Motor vehicle accidents are responsible for as many as two thirds of cases. 11 Additional causative injuries include interpersonal altercations, hanging, direct blows to the neck, chiropractic manipulation, and sporting accidents. Minor trauma such as coughing, 12 nose blowing, 13 and brushing teeth 14 are additional causes for carotid artery dissection.…”

“…The neurologic symptoms include nonspecific cerebellar and brain stem ischémie manifestations such as vertigo, dizziness, and hemisensory and motor symptoms. 11 • 29 Wallenberg's syndrome has been reported to develop in as many as one third of patients and consists of ipsilateral palatal paresis, true vocal cord weakness, Homer's syndrome, and a crossed sensory deficit.…”

Internal Carotid Artery Stenosis Due to Atherosclerotic Plaque Damage after Whiplash Injury

“…The diagnosis of blunt ICA injury is often difficult at the time of initial presentation. Because it is unsuspected, there are few (if any) external signs, it is often masked by more obvious injuries, there is often a delay in the appearance of signs, and the results of initial head CT are often normal2,5,6 . Early diagnosis can only be achieved by suspecting the injury and following up the patient with repeated neurological examination2,5,6 .…”

“…Because it is unsuspected, there are few (if any) external signs, it is often masked by more obvious injuries, there is often a delay in the appearance of signs, and the results of initial head CT are often normal2,5,6 . Early diagnosis can only be achieved by suspecting the injury and following up the patient with repeated neurological examination2,5,6 . Thus, one must always keep in mind the causes and mechanisms of blunt carotid injury and intervene before cerebral infarction occurs2,5,6 .Suggested mechanisms of ICA injury include: hyperextension of the neck with contralateral rotation of the head, a direct blow to the neck, blunt intraoral trauma, skull base fractures injuring the intrapetrous portion of the vessel, therapeutic and diagnostic carotid massage , and attempted strangulation 1!7 .…”

“…Early diagnosis can only be achieved by suspecting the injury and following up the patient with repeated neurological examination2,5,6 . Thus, one must always keep in mind the causes and mechanisms of blunt carotid injury and intervene before cerebral infarction occurs2,5,6 .Suggested mechanisms of ICA injury include: hyperextension of the neck with contralateral rotation of the head, a direct blow to the neck, blunt intraoral trauma, skull base fractures injuring the intrapetrous portion of the vessel, therapeutic and diagnostic carotid massage , and attempted strangulation 1!7 . Two areas are most frequently involved: (1) the cervical segment of the ICA, usually 1 to 3 cm above its bifurcation, and (2) the part of the vessel near the base of the skull and just distal to the origin of the posterior communicating artery 2,7,8 .…”