Blunt Traumatic Carotid Dissection in a Near-Hanging Victim: Comparative Description of Findings Between Doppler Ultrasound,Computerized Tomography Angiography,and Intraoperative Angiography

Abstract

A 27-year-old male with a history of psychiatric treatment and drug abuse was brought to the hospital after a suicide attempt by hanging. Due to his stable condition and no neurological deficits, a computerized tomography angiography (CT-Angio) was performed and revealed a circumferential intimal disruption of the distal left common carotid artery (CCA), compatible with a blunt traumatic carotid dissection (Amussat’s sign). Doppler ultrasound (DUS) confirmed a dissection with high peak systolic velocity (PSV) of 278 cm/s. Based on these dynamic imaging findings, an endovascular approach for repair was chosen, and a dual-mesh carotid stent was successfully deployed. The postoperative course was uneventful. At 6-month follow-up, the patient remains neurologically asymptomatic with a patent stent. This case highlights the importance of clinical suspicion for blunt traumatic carotid dissections and supports the utility of DUS in both diagnosis and follow-up.

Keywords

carotid trauma neck trauma carotid dissection Doppler ultrasound carotid stenting

Get full access to this article

View all access options for this article.

References

Manuel

Melo

RGE

Fernandes

RFE

, et al. Endovascular repair of bilateral carotid dissection in a near hanging victim. EJVES Short Rep. 2018;40:21-25. doi:10.1016/j.ejvssr.2018.08.003.

Wahlgren

Aylwin

Davenport

, et al. Editor’s choice—European Society for Vascular Surgery (ESVS) 2025 clinical practice guidelines on the management of vascular trauma. Eur J Vasc Endovasc Surg. 2025;69(2):179-237. doi:10.1016/j.ejvs.2024.12.018.

Asensio

Mazzini

, et al. Penetrating carotid artery: uncommon complex and lethal injuries. Eur J Trauma Emerg Surg. 2011;37(5):429. doi:10.1007/s00068-011-0132-3.

Lee

Ducic

Gordin

Stroman

Management of carotid artery trauma. Craniomaxillofac Trauma Reconstr. 2014;7(3):175-189. doi:10.1055/s-0034-1372521.

Chiba

Makino

Motomura

, et al. Bilateral middle cerebral artery infarction associated with traumatic common carotid artery dissection: a case report and review of literature. Forensic Sci Int. 2014;236:e1-e4. doi:10.1016/j.forsciint.2014.01.003.

Montorfano

Pla

Vera

Cardillo

Nigra

Montorfano

LM.

Point-of-care ultrasound and Doppler ultrasound evaluation of vascular injuries in penetrating and blunt trauma. Crit Ultrasound J. 2017;9(1):5. doi:10.1186/s13089-017-0060-5.

Bynoe

Miles

Bell

, et al. Noninvasive diagnosis of vascular trauma by duplex ultrasonography. J Vasc Surg. 1991;14(3):346-352.

Arnold

Baumgartner

Stapf

, et al. Ultrasound diagnosis of spontaneous carotid dissection with isolated Horner syndrome. Stroke. 2008;39(1):82-86. doi:10.1161/STROKEAHA.107.492652.

Sturzenegger

Mattle

Rivoir

Baumgartner

RW.

Ultrasound findings in carotid artery dissection: analysis of 43 patients. Neurology. 1995;45(4):691-698. doi:10.1212/wnl.45.4.691.

10.

Kremer

Mosso

Georgiadis

, et al. Carotid dissection with permanent and transient occlusion or severe stenosis: long-term outcome. Neurology. 2003;60(2):271-275. doi:10.1212/01.wnl.0000043580.70857.92.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB