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Internal carotid artery dissection following wooden arrow injury to the posterior pharynx. Case report.

In this report the authors describe a case of internal carotid artery (ICA) dissection following a blunt posterior pharynx injury and review current literature on the identification and treatment of such disorders. An ICA dissection developed in a 6-year-old boy who had suffered blunt injury to the posterior pharynx and who was followed up via computed tomography (CT) angiography and clinic visits for 6 months. The ICA dissection healed with pseudoaneurysm development and was treated with anticoagulation therapy. The authors searched the January 1996 through March 2007 MEDLINE database by using the Ovid search engine. They requested all English-language articles with the term "carotid dissection." Reference lists from these articles were retrieved and searched for additional relevant sources. The authors found that given its availability and speed of acquisition, CT angiography typically is the preferred initial diagnostic method. Magnetic resonance angiography is usually recommended for follow-up examination especially in pediatric cases. According to the available literature, the current preferred treatment for ICA dissection is anticoagulation.