DIAGNOSIS OF BLUNT CAROTID INJURY IN PATIENTS WITH FACIAL TRAUMA

Objectives. The purpose of this study was to review the clinical and d iagnostic findings associated with blunt carotid artery injury, provid e information related to clinical outcome, and report the findings of a retrospective study comparing patients with nonpenetrating and penet rating carotid artery injuries and the attendant facial injuries. Stud y design. Twenty-one patients admitted to the hospital nonelectively w ith a subsequent diagnosis of penetrating (11 patients) or nonpenetrat ing (10 patients) carotid artery injuries were included in the study. Records were analyzed for demographic data, mechanism of injury and ti me to diagnosis, neurologic status, presence of facial injuries, and o utcome. Results. Five patients had facial injuries associated with a b lunt carotid artery abnormality; six patients had penetrating carotid wounds. Time from carotid injury by all mechanisms to diagnosis was 20 minutes to 12 hours (mean 4 hours). Seventeen patients survived their injury. Conclusion. Patients with completely asymptomatic head injuri es and severe closed-head injuries must be given careful initial evalu ation and subsequent secondary evaluation. The relatively high frequen cy of facial injuries associated with blunt carotid injury should aler t the maxillofacial surgeon to consider the diagnosis.