Delayed Stroke following Blunt Neck Trauma: A Case Illustration with Recommendations for Diagnosis and Treatment

• Published in: Case reports in emergency medicine Vol. 2017; no. 2017; pp. 1 - 4
• Main Authors: Solomon, Rachele, Wessell, Jeffery, Treitl, Daniela, Anyama, Best, Rosenthal, Andrew
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt Hindawi Publishing Corporation 01.01.2017; Hindawi; John Wiley & Sons, Inc; Hindawi Limited
• Subjects: Blood clots; Blunt trauma; Brain research; Care and treatment; Carotid artery; Case Report; Case studies; Complications and side effects; Dissection; Fractures; Health aspects; Injuries; Medical diagnosis; Medical imaging; Neck; NMR; Nuclear magnetic resonance; Patients; Risk factors; Stroke; Stroke (Disease); Thrombosis; Trauma; Ultrasonic imaging; Veins & arteries
• ISSN: 2090-648X; 2090-6498
• DOI: 10.1155/2017/3931985

Blunt cerebrovascular injury (BCVI) to the carotid artery is a relatively rare injury that is difficult to identify even with imaging. Any symptoms or neurological deficits following blunt neck injury mandate evaluation and consideration of BCVI. In an effort to highlight this issue, we report the case of a 31-year-old male patient who presented with left-sided weakness consistent with transient ischemic attack (TIA) and concussion. The patient’s symptoms occurred within 24 hours of a blunt neck injury sustained by a knee strike during a basketball game. An initial computerized tomography (CT) scan of the brain was normal; a CT angiogram (CTA) of the neck and carotids did not reveal obstruction, dissection, stenosis, or abnormalities of the carotid or vertebral vessels and the patient was subsequently discharged. A magnetic resonance imaging (MRI) of the brain obtained four days after the initial injury demonstrated an acute infarct in the right middle cerebral artery (MCA) territory. Thus, despite initial negative imaging, neurological deficits must be aggressively pursued in order to prevent stroke in BCVI cases.