DISECCIONES CAROTIDEAS POST-TRAUMATICAS

We report three patients with cerebral infarcts related to traumatic dissection of carotid arteries. Two patients had penetrating trauma secondary to either gunshot or knife wound, while the other patient had a nonpenetrating trauma. Carotid angiograms revealed occlusion of the extracranial internal carotid artery in two patients, and a pseudoaneurysm formation without luminal stenosis in the common carotid artery in the remaining case. Cerebral infarcts were related to hemodynamic compromise from carotid occlusion in two patients, and from embolism of thrombotic fragments in the other patient. The patients with the pseudoaneurysm formation was operated on with almost complete recovery, and the two patients with carotid occlusion also improved with conservative therapy. Prompt diagnosis of this condition in patients with cervical trauma is important in order to start early therapy which reduces the risk of delayed cerebral ischemia.