Delayed hemiparesis following nonpenetrating carotid artery trauma

Abstract

A 21-year-old man developed transient, recurring right arm and leg weakness 2 weeks after a motorcycle accident. He ultimately proved to have an intimal tear and thrombosis of the left internal carotid artery with transient cerebral ischemia due to distal emboli. Neurologic deficits eventually resolved after anticoagulation and balloon occlusion of the vessel. The differential diagnosis of the patient's presentation is discussed, and the topic of nonpenetrating trauma of the carotid artery is reviewed, with special attention to mechanism of injury and clinical presentation.