PEDIATRICS Vol. 84 No. 1 July 1989, pp. 128-132
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Traumatic Monocular Blindness and Associated Carotid Injuries

MICHAEL A. KING MD1, ANTHONY J. BARKOVICH MD2, VAN V. HALBACH MD2, GRANT B. HIESHIMA MD2, and MICHAEL S. B. EDWARDS MD3

1 Division of Pediatric Neurosurgery, Dept of Neurological Surgery, University of California, San Francisco San Francisco, CA
2 Dept of Radiology (Neuroradiology), University of California, San Francisco, San Francisco, CA
3 School of Medicine, University of California, San Francisco, San Francisco, CA

Cases of traumatic carotid injuries have been described sporatically in the literature since the early 19th century. The general availability of angiography in the 1930s caused a significant increase in the number of articles published concerning this subject, but reports of carotid artery injuries remain uncommon. In one series of 2000 head injury patients, carotid injuries were recognized in only 0.5% of patients.

Of the various types of injury the carotid artery can sustain, the development of intracavernous false aneurysm is potentially the most devastating. The syndrome of traumatic monocular blindness and severe delayed epistaxis in association with carotid injuries and basilar skull fractures was first reported by Barth and more recently by Chambers et al. Mortality rates of 20% to 40% have been attributed to a delay in diagnosis.

Submitted on April 8, 1988
Accepted on August 29, 1988