BILATERAL BLUNT TRAUMATIC DISSECTIONS OF THE EXTRACRANIAL INTERNAL CAROTID-ARTERY - REPORT OF 11 CASES AND REVIEW OF THE LITERATURE

Of 20 patients with blunt traumatic dissections of the extracranial in ternal carotid artery, 11 had bilateral lesions. Mean age was 26.6 yea rs (range 19-44). All patients were involved in motor vehicle accident s. All had sustained head injuries which were mild in 6 and severe in 5. Five of 11 patients had additional thoracic trauma and 2 had whipla sh injuries. Seven patients developed unilateral hemispheric symptoms with a latency ranging from 4 h to 4 weeks. Outcome was good in 5 pati ents, moderate deficits persisted in 3, and 3 patients died. Based on our personal cases and a brief review of 28 additional cases from the literature, no discriminating differences between bilateral and unilat eral lesions emerged with regard to mechanism of injury, clinical pres entation, angiographic lesion type, or outcome.