[Thrombosis of the internal carotid artery following blunt surgical trauma (author's transl)]

Abstract

We report the possible first case of carotid artery thrombosis associated with surgical removal of the styloid process. Our patient, a 49-year old woman, developed acute thrombosis of the internal carotid artery two days following transoral removal of an elongated styloid process through the tonsillar fossa. The pathogenesis, diagnosis and therapy of posttraumatic carotid artery thrombosis are discussed, inclusive of surgical trauma. A hemiparesis without loss of consciousness one to two days after blunt cervicofacial trauma is typical for a carotid thrombosis. In most cases, the obstruction is located in the extracranial portion of the internal carotid artery, and should be verified as soon as possible by carotid arteriography. Surgical thrombectomy rather than conservative management gives the better chance for survival as well as recovery from neurological deficits.