Traumatic carotid artery dissection: Early treatment by stenting is effective

Abstract

  A blunt traumatic carotid artery injury is often associated with multiple traumas, and can cause a brain infarctions in the delayed phase, and it is crycial to diagnose and treat this injury without delay. We report four cases of blunt carotid artery injury, including descriptions of the carotid artery dissection. The effectiveness of antithrombotic therapy, and the period of carotid artery stenting (CAS) in each case are addressed. (1)A 44‒year‒old male suffered systematic injuries at traffic accident. On hospitalization day 12, computed tomography revealed a left internal carotid artery dissection. (2)A 56‒year‒old male suffered a right common carotid artery dissection due to a traffic accident. (3)A 37 year‒old male with systematic injury suffered left internal carotid artery dissection. (4)A left carotid artery dissection was detected 6 months after an injury in a 53‒year‒old female. In the acute phase when there was a risk of hemorrhage from an accompanying injury, anticoagulant therapy with intravenous heparin was administered for stroke prevention. We started antiplatelet therapy when the hemorrhage risk became sufficiently negligible, and CAS was planned. In all four cases, no brain infarction was observed after the CAS. For patients with a blunt carotid artery injury, early treatment by CAS is effective to prevent brain infarction.