Asymptomatic carotid artery dissection caused by blunt trauma.

A 42-year-old man presented with asymptomatic traumatic carotid artery dissection 3 months after sustaining blunt injury with tracheal laceration. Magnetic resonance imaging performed as a screening procedure for asymptomatic carotid artery injury unexpectedly showed dissection of the carotid artery. Angiography confirmed carotid artery dissection with narrowing of the true lumen. Balloon angioplasty and stent placement were carried out to dilate the true lumen and isolate the false lumen from blood flow. Intravascular ultrasonographic virtual histology defined the precise anatomic structure of the lesion and identified the internal flap as fibrotic. Careful clinical assessment of patients with blunt cervical trauma may permit diagnosis of carotid artery dissection and intervention prior to the development of cerebral ischemic symptoms.