Intimal disruption of major cerebral vasculature following blunt trauma.

A child with blunt traumatic intimal disruption involving the major vessels responsible for cerebral circulation was treated by operation. The injured vessels included both common carotid arteries, both vertebral arteries, and the left subclavian artery. The carotid injuries were treated by saphenous vein interposition grafts, whereas the left subclavian and vertebral arteries were ligated. The patient sustained no neurological deficit and is now completely well 2 years after treatment. The case reported herein is unique in that total intimal disruption of the four major vessels responsible for cerebral flow was treated by operation, resulting in complete recovery. The successful outcome underscores the importance of complete angiographic evaluation and adequate operative exposure in such cases.