Traumatic Internal Carotid Artery Injuries: Do We Need a Screening
Strategy? Literature Review, Case Report, and Forensic Evaluation

Aniello       Maiese; Paola       Frati; Alice    Chiara    Manetti; Alessandra       De Matteis; Marco       Di Paolo; Raffaele       La Russa; Emanuela       Turillazzi; Alessandro       Frati; Vittorio       Fineschi
Abstract

Internal carotid artery dissection (ICAD) represents the cause of ictus cerebri in about 20% of all cases of cerebral infarction among the young adult population. ICAD could involve the extracranial and intracranial internal carotid artery (ICA). It could be spontaneous (SICAD) or traumatic (TICAD). It has been estimated that carotid injuries could complicate the 0,32% of cases of general blunt trauma and the percentage seems to be higher in cases of severe multiple traumas. TICAD is diagnosed when neurological symptoms have already occurred, and it could have devastating consequences, from permanent neurological impairment to death. Thus, even if it is a rare condition, a prompt diagnosis is essential. There are no specific guidelines regarding TICAD screening. Nevertheless, TICAD should be taken into consideration when a young adult or middle-aged patient presents after severe blunt trauma. Understanding which kind of traumatic event is most associated with TICAD could help clinicians to direct their diagnostic process. Herein, a review of the literature concerning TICAD has been carried out to highlight its correlation with specific traumatic events. TICAD is mostly correlated to motor vehicle accidents (94/227), specifically to car accidents (39/94), and to direct or indirect head and cervical trauma (76/227). As well, a case report is presented to discuss TICAD forensic implications.
Keywords: Internal carotid artery dissection, trauma, diagnostic screening, cervical trauma, neurological impairment, direct or indirect trauma.
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Graphical Abstract

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DOI https://dx.doi.org/10.2174/1570159X19666210712125929	Print ISSN 1570-159X
Publisher Name Bentham Science Publisher	Online ISSN 1875-6190
Current Neuropharmacology

Traumatic Internal Carotid Artery Injuries: Do We Need a Screening Strategy? Literature Review, Case Report, and Forensic Evaluation

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