Bilateral thrombosis of the internal carotid arteries after a closed trauma. Advantages of magnetic resonance imaging and review of the literature.

Bilateral traumatic dissection of an internal carotid artery (BTDIC) after a closed injury is very rare. We report a case of bilateral thrombosis caused by internal carotid artery dissection due to a closed injury. The 22 cases documented in the literature are also reviewed. Six of the patients (26%) were asymptomatic at the initial examination, but all developed secondary symptoms, during the first 48 hours. Sixteen patients (69%) had associated traumatic lesions. Six patients died during the week after the accident, all of them had initial neurological symptoms. Magnetic resonance imaging (MRI) provided more items of information than angiography, showing a dissection on an occluded artery and a clearer picture of the length of the dissection, directly visualizing the wall hematoma and a residual signal that showed the persistence or arrest of blood flow. Treatment of BTDIC is based on early anticoagulation therapy.