TRAUMATIC CAROTID AND VERTEBRAL ARTERY DISSECTION IN A PROFESSIONAL JOCKEY - A CAUTIONARY TALE

Jockeys accept bony fractures and soft tissue injuries as occupational hazards. An average National Hunt jockey falls once in ten races with an injury rate of 4.25%(1). Head injury is a common cause of morbidit y and the benefit of helmets is well recognized. Neck injuries are als o common and usually musculoskeletal. Although rare, trauma to the nec k arteries may go unnoticed yet have catastrophic consequences. Intern al tears can allow arterial blood to dissect the layers of the arteria l wall and obstruct the lumen. Severe obstruction may lead to cerebral ischaemia and infarction. An appreciation of the early clinical signs caused by this process may allow effective intervention. We report a case which illustrates these points.