The Carotid Artery Thrombosis Following Blunt Neck Trauma; a Case Report
Introduction: This case emphasizes on the importance of detecting thrombosis and carotid artery injuries and the need for rapid treatment of blunt neck traumas. Case presentation: A 43-year-old male motorcyclist rider, rode into a rope and suffered blunt neck trauma. At admission to the emergency department (ED), he was fully conscious with Glasgow coma scale of 15. The biochemical tests and X-rays were normal, but initial examination revealed paresthesia in the right-hand fingertips, which exacerbated over the first 24 hours of admission. Doppler ultrasound of the neck arteries and computed tomography (CT) angiography reports showed thrombosis of the right common carotid artery, which spread to the right subclavian and vertebral arteries. Treatment was initiated with heparin injection followed by daily administration of oral warfarin, and seven days later, symptoms were relatively improved. Conclusion: Considering possible vascular injuries following blunt neck trauma should be kept in mind when dealing with such patients, and necessary physical examination required to rise the impression. By reviewing the literature, it seems that although CT angiography is usually used in screening carotid injuries, this modality appears to have poor sensitivity in this regard, and digital subtraction angiography (DSA) is still considered the gold standard for detecting carotid artery injury.
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