BLUNT CAROTID INJURY IN CHILDREN

Blunt carotid injury (BCI) is a rare entity which can have devastating neurologic consequences, Little has been reported on the mechanism of injury, presentation or management of these injuries in children. We present a series of 5 children with BCI, One patient died at presentat ion while the remainder developed delayed infarctions. Three surviving patients developed intracranial hypertension and required intracrania l pressure (ICP) monitoring. Surgical resection of infarcted tissue wa s required to control ICP in 2 patients, All four surviving patients a re impaired but ambulatory, We propose an aggressive management strate gy for BCI aimed at early detection of deficit, early angiography, ant icoagulation if appropriate, and active management of ischemia includi ng hemodynamic treatment, ICP monitoring, and active use of medical an d surgical means to monitor and control intracranial hypertension.