Internal carotid artery dissection at the supraclinoid portion after severe traumatic head injury in a child

Abstract

A 14-year-old boy with severe traumatic brain injury (TBI) and cranial fractures was admitted to our emergency department after a motor vehicle accident. An emergency craniotomy was performed, and traumatic carotid artery (CA) dissection (tCAD) was revealed by cerebral angiography. The patient then underwent close observation in the intensive care unit. Traumatic CADs are difficult to diagnose in the early period after injury, and are associated with serious problems and a high mortality rate. There is still a lack of knowledge surrounding its natural history and treatment options, especially in children. Moreover, it commonly occurs at the cervical internal CA, and tCAD at the supraclinoid portion is quite rare. To the best of our knowledge, this is the first report accompanied by radiological images of the clinical course of tCAD at the supraclinoid portion following severe TBI in a child.