Traumatic Thrombosis of the Internal Carotid Artery

False Aneurysm of the Carotid Artery With Horner's Syndrome Due to Blunt Trauma

“…The pathogenesis of carotid injury is traction, followed by a tear in the intima or the media, platelet aggregation and subsequent thrombosis, embolism and cerebral ischaemia. Carotid injury due to hyperextension of the neck causing longitudinal traction and impingement against the lateral mass of the atlas [6] and transverse process of the spine [7] is reported. It can also occur following acute hyperlexion injury, causing compression between the mandible and spine [3].…”

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

“…1955, Dratz and Woodhall 1947, Fletcher et aI. 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.…”

“…Indeed, the carotid has been injured by manipulation by physicians, as in testing for carotid sinus hypersensitivity (Calverley andMillikan 1961, Nelson andMahru 1963) or during surgery (Calverley andMillikan 1961, Linell andTom 1959). In missile wounds without direct injury, forces transmitted against the vessel wall have also resulted in thrombosis (Caldwell and Hadden 1948, Clarke et al 1955, Frantzen et al 1961, Gurdjian et al 1963, Linell and Tom 1959, Little et al 1969, Murray 1957, Northcroft and Morgan 1944, Raney 1948, Zilka 1970. Blunt trauma can also be delivered to the carotid artery in intraoral injuries since the artery lies close to the surface of the tonsillar fossa (Bickerstaff 1964, Braudo 1956, Caldwell 1936, Fairburn 1957, Miller and Ayers 1967, Pitner 1966, Scott et al 1960, Shillito 1964.…”

“…Force could also be applied along the long axis of the vessel by stretching by rotation or extension of the neck (Garg et al 1968, Gleave 1966, Homer et al 1970, Lewin 1968, Little et al 1969, and this mechanism was suggested in 25% of cases without neck injury (Fleming and Petrie 1968). Downward pressure on the shoulder could produce similar stresses (Garg et al 1968).…”

“…When a atheroma is present in the internal carotid artery, this may be disrupted by trauma and act as a nidus for thrombus formation (Little et al 1969, Ojeman and Moser 1964, Robinson 1961, Toakley and McCaffrey 1965, Yamada et al 1967. On the other hand, in older patients where the carotids have become ectatic, the vessel might be expected to unwind rather than to stretch, which might provide some protection (Little et al 1969). Local anatomical features are also important.…”