Penetrating carotid arterial trauma

Injury to the carotid arteries from penetrating occurred in 15 patients during a recent 4-year interval. Fourteen of the injuries involved the common and/or internal carotid arteries, while one isolated external carotid injury was also encountered. Gunshot wounds accounted for eight injuries (53%) and sharp-edged instruments for seven injuries (47%). Surgical management included six ligations and nine vascular repairs. Neurologic status was normal on admission in eight patients, all of whom did well. Seven patients had preoperative neurological deficits; all three mortalities occurred in these patients. Identification of a preoperative deficit is significant because it conferred a guarded prognosis. However, hypotension and even circulatory arrest did not preclude recovery.