Blunt internal carotid artery trauma: report of two cases and review of the literature.

Blunt injury of the internal carotid artery (ICA) is a rare entity that should be considered by Maxillofacial surgeons in patients with facial fractures. Its recognition is often delayed because of the common association with other severe multi-system injuries. Early diagnosis is the key to successful management; the arteriography plays a confirmatory role on the diagnosis and determines whether surgical management of the injury is feasible. Therapeutic alternatives vary from one center to another; they include observation, conservative treatment, anticoagulation, ligation of the carotid artery with or without extracranial-intracranial bypass, and arterial reconstruction.