This article explores the management of carotid arterial injuries, detailin
g the historical evolution for the management of these injuries and delinea
ting techniques for cerebral perfusion and preservation with shunts. It dis
cusses the role of autogenous versus synthetic grafts in the management of
these injuries and the issue of vascular complications and potential pitfal
ls. Jugular venous injuries are addressed also, with emphasis on the contro
versies of primary repair versus ligation.