Trauma to the intracranial internal carotid artery.

BACKGROUND: : A 4-year retrospective review of injury to the intracranial internal carotid artery at the skull base was undertaken to assess the impact of the injuries and their consequence in both the adult and the pediatric population.

METHODS: : The trauma registry followed by confirmatory chart reviews provided the total number of admissions, the mode of injury, demographics, and subdivided the trauma patients into the different groupings used in this study.

RESULTS: : In our series, traumatic damage to the intracranial internal carotid artery represented 1.495% of all facial trauma seen during a 4-year period at a Level I Trauma Center. Of the 10 patients seen with injury to the intracranial internal carotid artery at the siphon, 3 were pediatric patents, and all of these ended with permanent neurologic deficits. Adults fared better, exhibiting either no neurologic symptoms or transient neurologic symptoms that resolved over time. The exception was a patient who expired in the Emergency Center from a clival fracture involving transaction of both intracranial internal carotid arteries.

CONCLUSIONS: : Traumatic damage to the intracranial internal carotid artery is a rare event fraught with the difficulty of early diagnosis in the midst of major life-threatening multiorgan trauma. Within the different age groups, adults fared better than children.