Traumatic injuries to the cervical vessels are relatively
uncommon and constitute only about 5–10%
of all vascular injuries. In about 25% of patients
with blunt head and neck trauma, the cervical vessels
are involved. The most common mechanism
is penetrating injuries, but the incidence of blunt
vascular trauma is probably underestimated because
related symptoms are often vague and not
recognized. The patients are mostly young, and
despite the low incidence, mortality and morbidity
are very high. Mortality is, in most series, between
5% and 40%, and persistent neurological consequences
are reported in up to 80% of patients.
Mortality is not only caused by massive bleeding and cerebral ischemia due to embolization or
thrombotic occlusion associated with the vascular
injury, but also secondary damage to the aerodigestive
tract (e.g., airway compression from a large
expanding hematoma).
The anatomical location and the often complex
associated injuries make traumatic cervical vascular
injuries extremely challenging.