Carotid artery thrombosis and cerebral infarction after multiple traumas

Abstract

Carotid artery thrombosis and concomitant brain infarction after blunt trauma are rare conditions. We report a 34-year-old woman with multiple traumas due to pedestrian car accident. At the time of initial visiting, she was somnolent and her Glasgow coma scale (GCS) score was 14. Initial vital signs (V/S) and brain computed tomography (CT) scan were normal. One day after admission to the emergency observation unit, GCS improved to 15 but right-sided hemiparesis occurred. Magnetic resonance imaging (MRI) showed brain infarction and Doppler sonography indicated internal carotid artery thrombosis. She was admitted in the Neurosurgery ward and underwent anticoagulant therapy. With appropriate treatment, the patient's condition improved after 5 days of admission and she was discharged on oral warfarin treatment and close follow up. Although there is no ideal treatment for traumatic internal carotid artery thrombosis, it seems that in most cases anticoagulation therapy is the preferred method of treatment but in some patients surgical or endovascular revascularization is indicated.