The Neck is a cylindrical structure containing vital neurovascular and visceral structures tightly packed in a relatively small volume. Mortality rate increases when there is an injury to vascular structures especially the carotid artery, surrounded by other vital neurovascular structures; injuring the neck leads to devastating morbidity when compared to other
injuries. With increased awareness of screening techniques and improved detection rates, there is an urge in opting for selective neck exploration and initial aggressive antithrombotic
therapy for blunt
carotid artery injuries. Here we report a case of a 20-year-old male, with a lacerated injury of the right side of the neck causing transection of the right internal jugular vein, grade 4 (Denver classification) blunt carotid injury, along with cervical vertebral fractures without neurological deficits. The patient underwent emergency surgical neck
wound exploration, flush
ligation of transacted Right Internal Jugular Vein, and
conservative management for blunt
carotid artery injury using anti platelets (
Aspirin and
Clopidogrel) avoiding any immediate neurological deficits. Whenever lacerated neck
wounds are evaluated, the chance of
blunt injury to the carotid is to be borne in mind and such an injury can be managed with double antiplatelet
therapy, if there are no demonstrable neurological deficits.