TRAUMATIC INTERNAL CAROTID-ARTERY DISSECTIONS CAUSED BY BLUNT SOFTBALL INJURIES

This report describes recently treated patients with carotid artery di ssection caused by blunt softball injuries, as well as the results of a study of carotid artery trauma in a community. Data obtained through the medical records linkage system used for epidemiologic studies in Olmsted County, MN were used to identify all cases of traumatic intern al carotid artery dissection diagnosed from 1987 through 1994, Four pa tients with traumatic internal carotid artery dissections were identif ied during the 8-year period under study. In two patients (50%) the ca rotid dissection was a result of the direct impact of a softball. A 39 -year-old man, who developed transient cerebral ischemic symptoms, and a 35-year-old woman, who developed a painful Horner's syndrome, were struck by a softball on the anterolateral aspect of the neck. Both pat ients had a low carotid bifurcation. These data suggest that internal carotid artery dissections may be underrecognized sequelae of direct s oftball injuries to the anterolateral neck. A low carotid bifurcation may be a risk factor for such injuries. Copyright (C) 1998 by Saunders Company.