Traumatic Occlusion of the Internal Carotid Artery

Non-penetrating trauma to the carotid artery with secondary thrombosis and embolism: Treatment by Thrombolysin

“…These include a number of extensive and thoughtful reviews, some of which refer to the non-English literature, and in which up to 115 cases have been accumulated (Fleming and Petrie 1968, Garg et al 1968, Gleave 1966, Hornet et al 1970, Jernigan and Gardner 1971. Initial right common carotid arteriogram, a Lateral: Note lack of perfusion in middle cerebral artery distribution and thrombus in the extracranial portion of the right internal carotid artery, b AP: Note embolus in proximal portion of right middle cerebral artery and extrinsic pressure deformity along lateral aspect of extracranial internal carotid artery secondary to haematoma 1969, Mastaglia et al 1971, New and Momose 1969, Schneider et al 1971, Sullivan et al 1973, Towne et al 1972, Verbiest and Calliauw 1959, Yamada et al 1967, Zilka 1970. A typical clinical picture of symptoms and signs has been described, and certain variations have been noted.…”

“…Jaw fractures are often seen (Berman 1975, Caldwell and Hadden 1948, Garrison et al 1975, Hughes and Brownell 1968, Miller and Ayers 1967, Salmon and Blatt 1968, Schneider et al 1971, Silvernail et al 1975, Sullivan et aI. 1975, Toakley and McCaffrey 1965, Zilka 1970. Shoulder fractures or evidence of chest trauma can be seen (Garg et aI.…”

“…1968, Gleave 1966, Schneider and Lemmen 1952, Schneider et al 1971, suggesting that the carotid artery may have been stretched. Spinal fractures have also been seen (Houck 1964, Lai et al 1966, Zilka 1970. Basilar skull fractures may include the region of the carotid canal, the anatomy of which has some importance (Yashon et al 1964), and can cause secondary damage to the carotid artery (Garg et al 1968, Schneider et al 1971, Sedzimir 1955, Thompson 1963 Yashon et al 1964, Zilka 1970.…”

“…Where a subtotal occlusion is noted, a traumatic thrombus may be differentiated from atherosclerosis on angiography because the region involved in the former is usually long and involves the middle and distal thirds of the cervical internal carotid artery (Miller and Ayers 1967), while the latter generally occurs at the carotid bifurcation. A gradual narrowing may indicate that the initial obstruction was high (Zilka 1970).…”

“…1974, Gleave 1966, Gurdjian et al 1963, Horner et al 1970, Lewin 1968, Linell and Tom 1959, Little et al 1969, MacKintosh 1965, Murray 1957, Northcroft and Morgan 1944, Ritchie 1961, Verbiest and Calliauw 1959, Yamada et aI. 1967, Zilka 1970. Where this was not obvious, either the search was possibly not extensive enough, or a small disruption may have been overlooked.…”