Traumatic carotid artery dissection in polytrauma: is conservative treatment an adequate strategy? A case report
Accepted: May 21, 2024
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We present the case of a 24-year-old man, involved in a car accident, with a traumatic right carotid artery dissection Grade II Blunt CerebroVascular Injury (BCVI) according to the Eastern Association for the Surgery of Trauma (EAST). The patient arrived at our hospital without neurological symptoms and was then admitted to the Intensive Care Unit (ICU) for neurological monitoring; antithrombotic and antiplatelet therapy was initiated and in line with current literature, no routine endovascular treatment was performed. Twenty-four hours post-trauma, the patient required an urgent abdominal surgical intervention under general anesthesia. Upon awakening, he presented with left hemiplegia. The CT scan revealed hypodensity in the front-insular region prompting an urgent endovascular procedure. Fourteen days post trauma the patient was discharged from the Stroke Unit with an unchanged neurological performance, despite receiving appropriate treatment for Grade II BCVI, as recommended in current literature. Our patient developed a severe neurological disability. Further discussions are needed.
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