BILATERAL THROMBOSIS OF THE INTERNAL CAROTID ARTERIES AFTER A CLOSED TRAUMA - ADVANTAGES OF MAGNETIC-RESONANCE-IMAGING AND REVIEW OF THE LITERATURE

Bilateral traumatic dissection of an internal carotid artery (BTDIC) a fter a closed injury is very rare. We report a case of bilateral throm bosis caused by internal carotid artery dissection due to a closed inj ury. The 22 cases documented in the Literature are also reviewed. Six of the patients (26%) were asymptomatic at the initial examination, bu t all developed secondary symptoms, during the first 48 hours. Sixteen patients (69%) had associated traumatic lesions. Six patients died du ring the week after the accident, all of them had initial neurological symptoms. Magnetic resonance imaging (MRI) provided more items of inf ormation than angiography, showing a dissection on an occluded artery and a clearer picture of the length of the dissection, directly visual izing the mall hematoma and a residual signal that showed the persiste nce or arrest of blood flow. Treatment of BTDIC is based on early anti coagulation therapy.