Traumatic carotid artery dissection: diagnosis and treatment

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  • 1 Department of Neurosurgery, University of Tennessee, and Semmes-Murphey Clinic, Memphis, Tennessee
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✓ Early diagnosis and successful management of traumatic carotid artery dissections require a high index of clinical suspicion. The diagnostic study of choice is cerebral arteriography. In this paper, 24 cases of traumatic carotid artery dissection are described. Presenting signs and symptoms include Horner's syndrome, dysphasia, hemiparesis, obtundation, and monoparesis. Patients detected early with mild neurological deficits fared well with treatment, while those with profound neurological deficits and delayed diagnoses had poor outcomes. Aggressive nonsurgical treatment is advocated including anticoagulation therapy for prevention of progressive thrombosis and arterial occlusion and/or distal arterial embolization with resultant cerebral ischemia. Direct surgical thromboendarterectomy is considered to carry high morbidity and mortality rates.

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Contributor Notes

Address reprint requests to: Clarence B. Watridge, M.D., Department of Neurosurgery, University of Tennessee, 956 Court Avenue, Room A-202, Memphis, Tennessee 38163.
  • 1.

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    Yashon D: Comment on Scherman BM, Tucker WS: Bilateral traumatic thrombosis of the internal carotid arteries in the neck: a case report with review of the literature. Neurosurgery 10:753, 1982 Yashon D: Comment on Scherman BM, Tucker WS: Bilateral traumatic thrombosis of the internal carotid arteries in the neck: a case report with review of the literature. Neurosurgery 10:753, 1982

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