Brazilian Neurosurgery (Dec 2023)

Traumatic Carotid Artery Dissection — A Case Report

  • Taís Otilia Berres,
  • Wagner Lazaretto Padua,
  • Artur Eduardo Martio,
  • Yasmynni Escher,
  • Luciano Bambini Manzato,
  • José Ricardo Vanzin,
  • Octávio Ruschel Karam,
  • Paulo Moacir Mesquita Filho

DOI
https://doi.org/10.1055/s-0042-1755453
Journal volume & issue
Vol. 42, no. 04
pp. e343 – e347

Abstract

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Traumatic carotid artery dissection (TCAD) usually occurs after a direct cervical trauma or blunt trauma that causes hyperextension and excessive rotation of the neck. The most frequent presentation of TCAD is stroke, with 80% of patients developing a stroke in the first week after the trauma. Recent data indicate that symptoms start later in non-survivors (19.5 hours after trauma) compared with survivors (12.5 hours). In this case report, a young boy, 14 years-old, developed TCAD after he fell from his bike. He developed ischemic stroke symptomatology in the eighth day of hospitalization, with full recovery of symtoms after acetylsalicylic acid (AAS) administration. The use of antithrombotic medication is recommended, aiming for better neurological outcomes and prevention of stroke in TCAD patients, as highlighted by our case. However, the treatment recommendations are based on observational studies and expert opinion, owing to the lack of concrete data on the treatment of carotid artery blunt trauma. New studies and data are required to improve diagnosis and treatment of TCAD.

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