Traumatic internal carotid artery thrombosis after impalement injury.

~ mpalement injuries of the oropharynx and particularly of the soft palate or the tonsillar region are relatively common in children. In most of the cases the impalement injury leads to laceration of the mucosa, tearing of the muscles of the palate and the pharynx, and bleeding and consecutive hematoma. Thrombosis of the internal carotid artery is a rare but devastating complication of impalement injuries. Because of the delayed onset of neurologic signs after the complete occlusion of the internal carotid artery, this life-threatemng situation can be overlooked easily. In 1936 Caldwell ~ was the first to report a case of posttraumatic thrombosis of the internat carotid artery after transoral impalement injury. We report a case of a 4-year-old child that illustrates the typical delayed neurologic symptoms after a traumatic occlusion of the internal carotid artery.