Complete reconstruction of a traumatic disruption of the carotid bulb.

The management of a patient with complete carotid bulbar disruption and transection of the ipsilateral cervical vertebral artery is presented. Internal carotid arterial emboli resulted in acute hemiparesis and altered consciousness. Total reconstruction of the carotid bulb was accomplished with reversed saphenous vein. Complete neurologic recovery was achieved. This approach of composite venous reconstruction of the carotid artery may be considered for selected patients with this complex vascular injury.