Blunt carotid injury is an uncommon finding in trauma patients and is typically seen when a patient is struck by an object moving at a high velocity, such as a flying hockey puck or baseball. The astute trauma surgeon will have a high index of suspicion and should evaluate using a combination of CT angiogram or carotid duplex of the neck to diagnose.
Classification of blunt carotid injury and suggested management strategies are listed below:
Grade | Description | Treatment |
I | < 25% compromise of lumen | anticoagulation |
II | 25% or > of lumen | anticoagulation or repair |
III | pseudoaneursym | anticoagulation, repair, possible delayed stent placement |
IV | thrombosis | anticoagulation |
V | transection | anticoagulation |
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